OverviewOur team members are the heart of what makes us better.At Hackensack Meridian Health we help our patients live better, healthier lives — and we help one another to succeed. With a culture rooted in connection and collaboration, our employees are team members. Here, competitive benefits are just the beginning. It’s also about how we support one another and how we show up for our community.Together, we keep getting better - advancing our mission to transform healthcare and serve as a leader of positive change.The Manager, Utilization and Care Coordination works in collaboration with Case Management and Leaders across HMH and provides a key role in facilitating long-term success of the Utilization/Care Management Programs by providing ongoing development, implementation, and oversight at the network level. This position works collaboratively with all department and site leaders, including all levels of the Population Health team. Educates and trains all clinical teams in EPIC, Xsolis and other care management software systems under Population Health. Creates all Knowledge builders, workflows and data reports with IT build teams and vendors. Performs audits on workflow processes to ensure compliance with Federal and State regulations.ResponsibilitiesA day in the life of a Manager, Utilization and Care Coordination at Hackensack Meridian Health includes:
Facilitates ongoing development, implementation and oversight of Epic related processes for Population Health.
Develops and builds EPIC, Xsolis, Careport and other new software workflow processes for Corporate Care Management and ensures compliance.
Responsible for management of the network Utilization and Care Management team.
Responsible for EPIC, Xsolis and Care Port training and education for all clinical teams in Population Health.
Partners with site leaders to ensure new team members are educated and trained on Epic, Xsolis and Care Port workflows.
Educates and trains new site leadership on EPIC, Xsolis and Careport workflows and reports.
Responsible for ensuring Epic, Xsolis and CarePort access for new team members.
Plans, organizes, and directs, projects, staff education and resource management.
Completes audits, data analysis, tracks and trends areas of improvement. Collection of delays in service data and data for specific performance and/or outcome indicators as determined by Xsolis, EPIC and BI reports.
Identifies needs and writes and/or collaborates with IT on new reporting, and modifications to existing reports.
Manages Centralized Staffing schedules.
Ensures appropriate Xsolis training modules are available to staff.
Responsible for facilitating Inter-rater reliability testing.
Serves as the Subject Matter Expert for EPIC, Xsolis and Care Port workflows in Corporate Care Management.
Ensures the corporate care management team workflows are compliant with Medicare and payer requirements. 16. Other duties and/or projects as assigned.
Adheres to HMH Organizational competencies and standards of behavior.
QualificationsEducation, Knowledge, Skills and Abilities Required:
Bachelor's degree in nursing (BSN).
6 years of case management experience.
Proficient in EPIC, and Xsolis and understands workflows.
Strong knowledge of CMS, Joint Commission and State regulations.
Knowledgeable regarding Reimbursement Systems & Insurance Coordination.
Excellent interpersonal communication skills.
Strong analytical and data management skills.
Excellent written and verbal communication skills.
Proficient computer skills including but not limited to Google Suite platforms.
Education, Knowledge, Skills and Abilities Preferred:
Experience in acute care settings.
Knowledge of EPIC, Xsolis and Care Port.
Licenses and Certifications Required:
NJ State Professional Registered Nurse License.
Licenses and Certifications Preferred:
Certified Case Manager.
If you feel that the above description speaks directly to your strengths and capabilities, then please apply today!Department Corp Care ManagementSite HMH Hospitals CorporationJob Location US-NJ-EdisonPosition Type Part-time with BenefitsStandard Hours Per Week 20Shift DayShift Hours DayWeekend Work Weekends as NeededOn Call Work On-Call Commitment RequiredHoliday Work As Needed
