Nurse Manager, Clinical Resource & Community Care - Full Time - DC

POSITION SUMMARY

The Manager, Clinical Resource & Community Care Management will report to the Director of Integrated Care Management. The Manager will lead, supervise, and evaluate the daily work of the Children's National Rehabilitation and Specialized Care Nurse Care Management and Social Work team, and Community Health Programs within the enterprise in accordance with departmental and organizational policies. Provide education within the inpatient setting and community health programs, departments, and the organization at large on clinical care, levels of care, and financial issues. Lead the clinical and financial processes that impact authorization for inpatient and outpatient services, net collections for hospital-based services, and pay for performance projects in the ambulatory settings. Analyze and report data related to case management activities, payer activities, resource utilization, and clinical denials. Lead hospital wide initiatives on behalf of the department. Define the role for care management by optimizing performance outcomes through readmission prevention, low acuity non-emergency (LANE) ED avoidance and reducing inpatient length of stay through comprehensive care planning that supports the highest level of symptom management in the home, school, community and/or ambulatory clinic.