Covenant Health

Coordinator-Quality and Care Management, Continuum of Care

Full Time, 80 Hours Per Pay Period, Day Shift

LeConte Medical Center Overview:

LeConte Medical Center is a part of Covenant Health, our region’s top-performing healthcare network and is a 79-bed community hospital located in the heart of Sevier County. We’re a full-service, not-for-profit hospital delivering modern medicine and compassionate care to the growing Sevier County community. LeConte offers a full range of health services, including top-tier specialists, a modern ER, and a beautiful Women’s Center. Learn more about our amazing facility at https://www.lecontemedicalcenter.com/about-leconte-medical-center/.

Position Summary:

The Coordinator of Quality and Care Management Services is responsible for the integration of the financial, clinical, and quality functions of Quality and Care Management under the supervision of the Manager of Quality and Care Management.  The Coordinator, in collaboration with the manager and the nurse manager is a leader, innovator and change agent in pursuit of seamless care of the patient across the continuum.  The Coordinator of Quality and Care Management Services promotes patient care continuity and quality through collaborative processes, evidenced based practice and quality improvement activities.  The Coordinator actively seeks opportunities to identify and implement best practices using a multidisciplinary approach.  The scope of practice encompasses the use of quality improvement principles and care management processes in pursuit of improved outcomes.

Position Accountabilities and Performance Criteria: 

The duties and responsibilities of this position are coordination of activities within the Quality and Care Management Quality Department as well as assume responsibility of managing the department in the absence of the Manager.  In addition, the Coordinator will function as a unit care manager, as deemed necessary. These duties and responsibilities include, but are not limited to:

Recruiter: Jennifer Lawless || apply@covhlth.com

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Performance Improvement:

• Serves as expert in performance improvement principles
• Identifies opportunities for improvement in Quality and Care Management
• Analyzes data to detect concerns; Implements actions to improve variances
• Evaluates actions to ensure improvement and continue to monitor performance for sustained progress.
• Actively participates in medical staff peer review activities

Clinical Resource:

• Assists in the design and implementation of evidenced based care in collaboration with physicians and other members of the health care team.
• Assists care managers in monitoring Core Measures and other department metrics.
• Oversees daily operations to maintain continuity of Care Management Process.
• Collaborates with nursing, Quality and Care Management and other health care professionals in the establishment of goals and implementation of the plan of care.
• 5. Stays abreast of HCAHPS results and implements actions to improve
• Collaborates and communicates effectively with the care managers, physicians and other members of the health care team. Attends meetings to disseminate data and data analysis.

Resource Utilization Management:

• Serves as a resource to Care Managers in Monitoring Medicare patients for continued stay criteria.
• Identifies and communicates variances in resource utilization to the appropriate member(s) of the health care team.
• Keeps abreast of regulatory requirements and educates staff and physicians and multidisciplinary staff members as needed. Provides an executive summary to the manager of any new regulations, operational changes or education needs.
• Assists the Manager in the preparation and dissemination of reports to appropriate stakeholders
• Assists the Manager with preparation of the monthly Scorecard. Presents the data at stakeholder meetings and other venues, as required.
• Serves as a Liaison between UM and Quality and Care Management.
• 7. Tracks data related to Performance Improvement activities; Assists with analysis of the data Reports trends and variances to Manager and Care Management Staff.
• Serves as a resource to Quality and Care Management staff to identify and implement actions to mitigate negative outcomes.
• Assists the Manager as a clinical resource for coders and case management staff for documentation improvement program.
• Identifies educational needs and recommends and assists in education of medical staff, nursing and other involved staff concerning care management products/objectives/methods, which may include, but not limited to, length of stay, resource utilization, regulatory compliance and reimbursement issues
• Participates as an active member of Revenue Cycle Team and other teams as requested.
• 12 Serves as an active member of Utilization Management Committee. Ensures that a strong relationship between all disciplines continues to grow with positive feedback for effective decisions.

Care Management:

• Serves as the Care Manager in designated area when necessary.
• Assists with planning, developing and delivery of educational materials designed to foster the patient’s, families and Physician understands of the plan of care.
• Seeks the most efficient, cost-effective ways to provide appropriate care.
• Participates in Quality Improvement initiatives as assigned.
• Ensures multidisciplinary rounds are completed and attended by the appropriate care givers

Staff Development:

• Participates in the recruitment, interviewing and orientation of, Staff Nurses, and other floor personnel, Quality and Care Management and Clinical Documentation as needed.
• Oversees new employee orientation and annual competency in Quality/Care Management.
• Assists with the development and updates policies and procedures.

   

General Duties:

• Follows policies, procedures, and safety standards. Completes required education assignments annually. Works toward achieving goals and objectives, and participates in quality improvement initiatives as requested.

Minimum Education :          

None specified; however, must be sufficient to meet the standards for achievement of the below indicated license and/or certification as required by the issuing authority.

Minimum Experience:        

Three (3) years of experience in case management with proven expertise in principles of quality and care management

Licensure Requirement:      

Current Tennessee RN License.  Current certification in Case Management (CCM), Certification in Quality (CPHQ) or Case Management (ACMA) is preferred but not required.