Position’s Location: Lansing, MI
General Purpose of Job:
Ensures that high quality case management services are achieved in collaboration with the multidisciplinary health teams. The Quality & Compliance Coordinator supports and carries out the vision of the department; produces excellence; performs compliance activities; ensuring Case Management complies with state and federal regulations.
This job description is intended to cover the minimum essential duties assigned on a regular basis. Caregivers may be asked to perform additional duties as assigned by their leader. Leadership has the right to alter or modify the duties of the position.
- Assists in compling operational metrics, to ensure a framework for optimal patient admission, length of hospital stay and discharge to accomplish a coordinated achievable discharge plan appropriate for the individual patient.
- Ensures case management caregivers adhere to and understand Centers for Medicare & Medicaid (CMS) Conditions of Participation pertaining to discharge planning and third party payers.
- Conducts audits and reviews to determine adherence to departmental policies, expectations, and requirements.
- Assists in establishing and maintaining department policies and procedures related to Case Management.
- Identifies opportunities for improvement and participates in department Performance Improvement, Corporate Compliance, Patient Satisfaction, Caregiver Engagement initiatives and monthly reporting of key operational information.
- Maintains departmental resources and education for individual insurance company requirements for discharge planning, and prior authorization processes.
- Assists in the development and achievement of department budget, goals and objectives.
- Monitors customer satisfaction, performance improvement and corporate compliance indicators, and key indicators of effectiveness and efficiency to ensure optimal performance.
- Assists in communicating shared vision, mission and values within departments, which motivates others to achieve strategic goals.
- Performs other administrative duties as delegated by the director.
|Specialized Knowledge and Skills|
Case Management Quality & Compliance
Sparrow Health System is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or protected Veteran status.
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