The Nursing Clinical Manager (NCM) for Case Management is responsible for the day to day management of the Case Managers. This includes, but is not limited to, daily supervision with the case managers, staff recruitment, retention, labor relations, daily staffing, employee performance evaluation, performance improvement, and staff education.
The NCM Manager serves as a resource/mentor for Case Managers, Social Workers and other institutional personnel, and participates in the development and implementation of new Institutional initiatives. The NCM reports to and assists the Director of Case Management in providing ongoing education to Case Managers and other hospital personnel as needed. The Nursing Clinical Manager collaborates with Appeals Management, Managed Care Contracting and other institutional departments to ensure contractual compliance and optimal reimbursement by Third Party Payers.
The Nursing Clinical Manager for Case Management has a collaborative reporting relationship with the Nursing Director for medicine and attends the monthly Nursing Leadership meeting.
1. Attends interdisciplinary rounds on units as warranted.
2. Meets with Case Managers, as warranted, to review medically complex and long stay cases; refer to physician advisor as indicated.
3. Collaborates with Social Work Supervisors to resolve discharge planning issues on assigned units.
4. Regularly reviews avoidable day data and provides follow-up with Case Managers on accuracy and completeness of avoidable days.
5. Oversees Case Managers interactions with physicians, nursing, social work, payors, patients and families.
Clinical Leadership:
1. Develops, implements, and maintains professional standards.
2. Ensures that the overall Case Management program supports patient, unit and clinical service objectives.
3. Provides operational and clinical oversite to case managers to insure that all day to day activity supports the mission of efficient and clinically appropriate patient care.
4. Demonstrates integral involvement in the Nursing Department PI/QA program. Participates in monthly Nursing Department meetings.
5. Works with unit case managers, clinical nurse managers, physicians, and social work to facilitate Interdisciplinary Rounds to ensure compliance with the patient management plan and the appropriate length of stay for each patient.
6. Conducts rounds on the inpatient units as warranted to determine and improve hindrances to appropriate length of stay.
7. Collaborates with the Director of Case Management to maintain, review and update all Case Management specialty policies in accordance with hospital, professional and regulatory standards.
8. Supports the overall strategic goals of the Hospital and the Nursing Department.
9. Attends interdisciplinary rounds as necessary.
10. Meets with Case Managers to review medically complex and long stay cases: refer to physician advisor as required.
11. Collaborates with Social Work Supervisors to resolve discharge planning issues on assigned units.
12. Regularly reviews avoidable day data and follow-up with Case Managers on accuracy and completeness of avoidable days.
Education Requirements
BSN, Masters Degree in Nursing or health related field.
Experience Requirements
Minimum of 5 years of case management experience and 5 -7 years of experience as a clinical nurse.
Licensing and Certification Requirements (if applicable)
License: RN (current) and Certification Issuing Agency: NYS/ Department of state
Name: Basic Life Saver (BCLS) Issuing Agency: AHA
Certification: NRP (Labor and Delivery, NICU dept)
Certification: ACLS (in ED; PACU/ASU; ICUs; Telemetry Units; SDU; IR, Interventional Cardiology (CCL/EP/Echo); L&D; Endoscopy, and APN Adult Oncology
Certification: PALS (in ED; PACU; IR; Peds ICU, and APNs Pediatric Oncology depts.)