Program Manager, Transitional Care
hace 16 días
Phoenix
Job Description Position Summary The Transitional Care Program Manager is responsible for ensuring the day-to-day program operations meet and where possible exceed the performance standards set for the targeted population being served. The Program Manager plays a key role with ensuring Patient Care Advocates and Navigators provide individuals enrolled in the Activate Transitional Program safe transitions from the hospital to their home; with the ultimate goal of reducing hospital readmissions. In this role the Program manager is responsible for day-to-day planning, implementing, and reporting as it relates to transitional care programs. Additionally, the Program Manager helps provide support and leadership for the CATCH Program which focuses on helping individuals access care at the preventative level. The Program Manager demonstrates knowledge and understanding of current best practices in transitional care programs. This position has 4-7 Direct Reports Essential Functions: % of Time Program Operations • Manages program operations for the communities, hospitals and clinic assigned, • Participates in meetings among AllThrive 365, Hospitals and Health Plans to achieve program goals, and actively contribute to problem solving with all partners, • Demonstrates an understanding of related hospital processes to ensure a comprehensive Patient handoff from the hospital to AllThrive 365, • Identify and obtains copies of the data necessary to track progress of all requested parameters requested by partners, • Collaborate with developing materials that integrate other AllThrive 365 programs into a seamless care package that can be promoted as a Capitated fee to insurers/hospitals to reduce readmissions of still-sick discharged patients, • Collects and analyzes data providing guidance and input measuring clinical outcomes, data procurement and analysis, including providing monthly reporting for stakeholders, • Maintains databases on care for patients and makes accurate and timely documentation, • Answers questions from patients and community members about transitional care programs, • Creates forms required in the implementation of the program, • Adheres to organizational policies and procedures with both AllThrive 365 and Dignity Policies Supervision and Direction • Participates in the hiring, disciplinary and termination processes for all Transitional Care employees, • Participates in the orientation of new personnel, mentors peers and promotes collaborative teamwork, • Provides supervision for staff working the roles of Patient Care Advocates, Navigators, and Support Staff providing guidance and resources, • Reviews weekly program outcomes related to both staff and patient outcomes with Programs Administrator, • Provides back-up for Patient Care Advocate functions including in-hospital identification, enrollment, home visits, and follow up care for patients, • Participates in and/or facilitates transitional care meetings and activities Continuous Improvement & Quality • Facilitates and/or participates in policy review and revisions, • Maintains a working knowledge of, and adheres to applicable federal / state regulations including, but not limited to, laws related to patient confidentiality, release of information, and HIPAA, • Works with Social Determinants of Health Director on continuous program improvement promoting quality, efficiency and effectiveness as it relates to process, procedures, and outcomes supported by data Miscellaneous Other duties as assigned 5% Requirements Education & Experience, Knowledge/Understanding Minimum Required: • Five years’ experience employed in roles that directly contribute to the healthcare or human service industry, • Possess a current RN or LPN license by the Arizona Board of Nursing or a Degree in Social Work, Human Services, Public Health, Public Administration from an accredited university., • A minimum of two years supervisory experience in the healthcare or human service industry, • At least one year of professional experience with elderly persons or demonstrated knowledge of geriatrics, • Possess a valid Arizona driver’s license and insurance, • Ability to pass hospital clearance requirements, • Must not have any restrictions for physical work for which reasonable accommodation cannot be made Preferred: • Have at least three years of clinical or social work/case management experience, • Have a BSN or college degree in related field, • Have a master’s degree in Social Work, Public Administration, or Health Administration Skills • Interacts in a professional, respectful, positive, helpful manner, which promotes trust, • Establishes effective working relationships with internal and external stakeholders, • Excellent verbal, written, reading, and listening communication skills to include communicating clearly, effectively, tactfully, and patiently to a diverse population., • Excellent interpersonal skills and demeanor with the ability to build rapport and garner trust with others., • Proficient in the use of a PC; in a Windows environment; in the use of the Internet; and in the use of MS Office Applications such as Outlook, Team, and Word., • Possess organizational skills to include time management and problem solving, • Knowledge of the social, psychological, physical, and spiritual aspects of the normal aging process, • Knowledge in a variety of therapeutic modalities including, but not limited to, behavior therapy, cognitive behavioral therapy, strengths-based therapy, systems therapy, Biofeedback and Autosuggestion, • Knowledge and skill pertaining to crisis intervention techniques Abilities • Ability to maintains member confidentiality, privacy, and dignity at all times, • Ability to lead the development of comprehensive and relevant treatment or care plans based on assessment and diagnosis, • Ability to model teamwork, professional communication, dependability, and flexibility, • Ability to maintain professional behavior in high pressure situations, • Ability to solve problems by applying analytical skills to include:, • collecting and reporting information, • Identifying trends and exceptions, • investigating to define problems more accurately, • sorting information in order of importance, • identifying relationships and linkages between components, • identifying variable potential causes and effects, • soliciting guidance to define criteria and assign values of importance and urgency, • escalating issues of an exceptional nature, • Willingness and ability to embody AllThrive 365’s core values:, • COMPASSION, • GROWTH, • RESILIENCE, • OPENNESS, • Acts in a manner consistent with the Corporate Compliance Program and Code of Conduct, • Possess excellent customer and interpersonal skills, • Ability to manage conflict, stress and multiple simultaneous work demands in an effective, professional manner, • Ability to work independently, while collaborating with other team members, • Ability to efficiently organize system approaches to facilitating services and activities, • Ability to adapt to changing patient or organizational priorities Physical Demands The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this position. • Works in a climate-controlled environment, infrequently outdoors, • Able to lift 25 pounds, • Requires bending, stooping, lifting, and standing for long periods of time, • Able to work under conditions of frequent interruptions, • Able to work with challenging behaviors expressed by members, i.e., verbal and physical aggressions, wandering, etc., • May be exposure to potentially infectious fluids such as blood or body fluids, • Exposure to latex, plastic, and/or materials which are used for personal protective equipment