The Clinical Nurse Manager (CNM) for Case Management is responsible for managing the day to day operations of the Case Management service. This includes, but is not limited to, daily supervision of the Case Managers, staff recruitment, retention, labor relations, daily staffing, employee performance evaluation, performance improvement, and staff education.
The CNM for Case Management 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. This position reports directly to the Director of Case Management and assists with providing ongoing education to Case Managers and other hospital personnel as needed. The CNM for Case Management collaborates with Appeals Management, Managed Care Contracting and other institutional departments to ensure contractual compliance and optimal reimbursement by Third Party Payers.
The CNM for Case Management has a collaborative reporting relationship with the Nursing Director for medicine and attends the monthly Nursing Leadership meeting. This position supports the overall strategic goals of the Hospital and the Nursing Department.
Duties and Responsibilities
1. Clinical Leadership:
a. Develops, implements, and maintains professional standards.
b. Insures that the overall Case Management program supports patient, unit and clinical service objectives.
c. Provides operational and clinical oversight to Case Managers to insure that all daily activity supports the mission of efficient and clinically appropriate patient care.
d. Demonstrates integral involvement in the Nursing Department's PI/QA program and participates in monthly Nursing Department meetings.
e. Works with unit case managers, clinical nurse managers, physicians, and social workers to facilitate interdisciplinary Rounds to ensure compliance with the patient management plan and the appropriate length of stay for each patient.
f. Conducts rounds on the inpatient units as warranged to determine and improve hindrances to appropriate length of stay.
g. 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.
h. Creates and maintains an environment of care where patients, families, staff and others are treated with respect, dignity and in a professional manner, promoting a respect for cultural diversity.
i. Attends interdisciplinary Rounds as necessary.
j. Meets with Case Managers to review medically complex and long stay cases; refer to physician advisor as required.
k. Collaborates with Social Work supervisors to resolve discharge planning issues on assigned units.
l. Regularly reviews avoidable day data and follow-up with Case Managers on accuracy and completeness of avoidable days.
a. Coordinates Case Managers' activities to maintain orderly flow of admissions and
b. Manages appropriate staffing plan for all Case Managers.
c. Conducts staff meetings with all Case Managers on a regular basis.
d. Encourages and facilitates professional growth and development of staff and ensures the flow of information from other departments to staff.
e. Promotes a positive environment that encourages staff to participate in the identification of areas of opportunity for improvement in length of stay.
f. Works with Case Managers on readmissions and ensures compliance with policy and regulations.
3. Management of Human Resources and Staff Development
a. Insures that personnel issues are managed in compliance with contractual agreements and supports positive employee-management relationships.
b. Collaborates with other nursing and hospital leaders to promote professional development of nursing staff.