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Position’s Location: Lansing, MI

Job Description

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.

Essential Duties:
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.

Job Requirements

General Requirements
  • Current Michigan Nursing License, or Michigan Licensed Master Social Work
  • CPHQ Certification or Certification in Case Management – preferred
Work Experience
  • Minimum of three years of experience in acute care case management
  • Previous experience with training or educational program development – preferred
  • BSN or LMSW
Specialized Knowledge and Skills
  • Demonstrates ability to handle multiple tasks concurrently.
  • Proficient with Microsoft Outlook, Word with 80% passing score
  • Demonstrates ability to quickly adapt to change and work with ambiguous parameters.
  • Demonstrates ability to work independently, organize and prioritize work to meet all deadlines.
  • Demonstrates excellent verbal and written communication
  • Demonstrate ability to work in stressful situations, manage conflict and assume a leadership role.
  • Maintains an atmosphere that supports and encourages high performance, high levels of Caregiver engagement, teamwork, customer service, and continual improvement within a specific area of responsibility.
  • Strongly supports the direction of Sparrow and the members of the Sparrow team
  • Ability to utilize word processing, spreadsheets, presentation programs and Microsoft Office
  • Ability to work with a team
  • Strong analytical and statistical abilities
  • Demonstrated organizational and time-management skills
  • Strong attention to detail
  • Demonstrates ability to use a keyboard as may be required to perform the essential duties of the job.

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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