Manager of Health Management/Population Health

Education: One of the following is required: Bachelor's of Science in Nursing or Master’s degree in Social Work or related field.  

Licenses/Certifications:

• Current and valid license to practice as Registered Nurse in the state of Texas or Licensed Master Social Worker (LMSW) or Licensed Clinical Social Worker (LCSW)
• An applicable certification such as: Case Management Certification (Certified Case Manager or Accredited Case Manager)
• For Remote Patient Monitoring/Quality Department Only: Case Management Certification is preferred

Experience/ Knowledge/ Skills:

• Three (3) years of experience in a leadership position in case management, and/or other cost/quality management program
• Five (5) years of experience in hospital-based nursing or social work preferred
• Knowledge of leading practice in clinical care and payor requirements
• Self-motivated, proven communication skills, assertive
• Background in business planning, and targeted outcomes
• Working knowledge of value based care, managed care, inpatient, outpatient, quality tactics, and case management
• Working knowledge of the concepts associated with Performance Improvement
• Must have evidence of leadership, creativity, integrity and initiative, and sound problem solving skills
• Ability to work collaboratively with and develop rapport with health care professionals, patients, and payors at all levels to achieve established goals and improve quality outcomes
• Ability to operate a personal computer, word processing programs, and navigate between multiple programs/systems
• Has a high level understanding of process-orientation, organization, and resourcefulness
• Must have evidence of leadership, creativity, integrity and initiative, and sound problem solving skills
• Have excellent written and verbal communication skills, impeccable negotiating skills, and the ability to interact with a wide variety of individuals and handle several complex situations simultaneously.
• Must have attention to detail and follow-up

Principal Accountabilities

• Supports growth and development of the ambulatory case management programs and consistent with enterprise wide philosophy and in response to the dynamic nature of the health care environment through benchmarking for best practices, networking and other activities as needed.
• Ensures the delivery of cost effective, community-based, and culturally sensitive case management interventions and continuous quality improvement monitoring.
• Collaborates to ensure patient outcomes that address the values of quality, services, and cost-effectiveness.
• Has ability to assess, analyze, and alter processes to the meet the ambulatory case management needs of referred patients.
• Responsible for coordinating day to day operations, drive for results and outcomes, and provide updates to Director as warranted.
• Participates in departmental personnel functions (onboarding, performance management,, etc.) in conjunction with the Director of Health Management.
• Provides input to annual and interim performance appraisal reviews for the staff in department.
• Acts as liaison to facilitate communication and collaboration between all care partners (physicians, hospitalists, community care managers, nurses, community resources, payers etc.)
• Responsible for leading a high performance team of “system thinkers” who incorporate leadership principles and vision in performing the functions of ambulatory case management.
• Uses data to drive decisions, plan, and implement performance improvement strategies for ambulatory care coordination.
• Ensures safe care to patients, staff and visitors; adheres to all Memorial Hermann policies, procedures, and standards within budgetary specifications including time management, supply management, productivity and quality of service.
• Promotes individual professional growth and development by meeting requirements for mandatory/continuing education and skills competency; supports department-based goals which contribute to the success of the organization; serves as preceptor, mentor and resource to less experienced staff.
• Demonstrates commitment to caring for every member of our community by creating compassionate and personalized experiences. Models Memorial Hermann’s service standards by providing safe, caring, personalized and efficient experiences to patients and colleagues.
• Other duties as assigned