Coord Quality and Care Mgmt

Overview

Coordinator, Quality and Care Management - Continuum of Care

Full-Time, 80 Hours Per Pay Period, Day Shift

Parkwest Overview:

Headquartered in Knoxville, Covenant Health is a community-owned integrated healthcare delivery system and the area’s largest employer.

Parkwest is Covenant Health’s and West Knoxville’s premier medical facility and a top-performing heart hospital, offering our patients world-class treatment with all the convenience and warmth of home.

In addition to providing the area’s leading cardiac services, Parkwest has been nationally recognized for award-winning care throughout our facility. For 2020-21, Parkwest received recognition from U.S. News & World Report as one of the “Top 10” hospitals in Tennessee.

Knoxville located in East Tennessee is the third largest in the state, well-known for its proximity to the Great Smoky Mountains National Park, and is the home of the University of Tennessee. Go Vols!  Living in Knoxville means experiencing all four seasons.  Best of all, each of them is pretty mild!

Combine all that with the abundant natural beauty of the surrounding mountains, and you have a city that truly offers something for everyone. Knoxville has a vibrant arts culture, seasonal festivals, top-notch foodie and incredible outdoor recreation. It’s a perfect blend of big-city amenities and Southern charm.

5 Riverstone, Acute-Renal, Pulmonary:

Located in the “Penthouse of Parkwest” 5 Riverstone is a 44-bed unit located on the 5th floor with beautiful views of the sunrise and sunset. The 5 Riverstone family is a diverse group of hardworking, dedicated individuals who use humor and teamwork to navigate out day-to-day work environment.

As a part of the 5 Riverstone Acute-Renal, Pulmonary team, you will see a large variety of patients including cardiac, pulmonary, and renal. Nurses on 5R have the opportunity to use their cardiac telemetry skills, operate various forms of oxygen delivery methods including tracheostomies (no ventilator patients), and care for pre/post hemodialysis and peritoneal dialysis patients. The population on the unit is highly varied from self-care patients to total care patients. Nurses collaborate daily with case managers, social workers, pharmacists, and therapists to develop individual patient care plans. 5 Riverstone provides a professional and stimulating environment where critical thinking, problem solving, and teamwork is both nurtured and expected.

Our team includes high quality RNs, LPNs, Patient Care Assistants, and Health Unit Coordinators. Our staff rotates ever other holiday and weekend. We utilize a preferred self-scheduling model that covers a six-week period to allow for flexibility. We welcome staff members of varying experiences, from new graduates to the experienced healthcare professional. Come join our amazing team on 5 Riverstone!

Position Summary:

The Coordinator of Quality and Care Management Services is responsible for the integration of the financial, clinical, and quality functions of Quality and Care Management under the supervision of the Manager of Quality and Care Management.  The Coordinator, in collaboration with the manager and the nurse manager is a leader, innovator and change agent in pursuit of seamless care of the patient across the continuum.  The Coordinator of Quality and Care Management Services promotes patient care continuity and quality through collaborative processes, evidenced based practice and quality improvement activities.  The Coordinator actively seeks opportunities to identify and implement best practices using a multidisciplinary approach.  The scope of practice encompasses the use of quality improvement principles and care management processes in pursuit of improved outcomes.Responsible for the integration of the financial, clinical, and quality functions for Care Management under the supervision of the department Manager. The position would help facilitate safe and efficient patient flow through the hospital and post-discharge placement. It would assist the Manager and staff with long length of stay patients and difficult discharges in the acute care setting through the coordination of resources. In addition, assume responsibility of managing the department in the absence of the Manager and function as a unit care manager, as deemed necessary. M-F, days, minimum of 3yrs nursing experience. CCM, ACM, or CPHQ prefered or obtained within 6 months.

Position Accountabilities and Performance Criteria:

The duties and responsibilities of this position are coordination of activities within the Quality and Care Management Quality Department as well as assume responsibility of managing the department in the absence of the Manager.  In addition, the Coordinator will function as a unit care manager, as deemed necessary. These duties and responsibilities include, but are not limited to:

Recruiter: Angelica Adams || [email protected] || 865-374-5405

Responsibilities

• Performance Improvement:
• Serves as expert in performance improvement principles
• Identifies opportunities for improvement in Quality and Care Management
• Analyzes data to detect concerns; Implements actions to improve variances
• Evaluates actions to ensure improvement and continue to monitor performance for sustained progress.
• Actively participates in medical staff peer review activities 
• Clinical Resource:
• Assists in the design and implementation of evidenced based care in collaboration with physicians and other members of the health care team.
• Assists care managers in monitoring Core Measures and other department metrics.
• Oversees daily operations to maintain continuity of Care Management Process.
• Collaborates with nursing, Quality and Care Management and other health care professionals in the establishment of goals and implementation of the plan of care.
• Stays abreast of HCAHPS results and implements actions to improve
• Collaborates and communicates effectively with the care managers, physicians and other members of the health care team. Attends meetings to disseminate data and data analysis.
• Resource Utilization Management:
• Serves as a resource to Care Managers in Monitoring Medicare patients for continued stay criteria.
• Identifies and communicates variances in resource utilization to the appropriate member(s) of the health care team.
• Keeps abreast of regulatory requirements and educates staff and physicians and multidisciplinary staff members as needed. Provides an executive summary to the manager of any new regulations, operational changes or education needs.
• Assists the Manager in the preparation and dissemination of reports to appropriate stakeholders
• Assists the Manager with preparation of the monthly Scorecard. Presents the data at stakeholder meetings and other venues, as required.
• Serves as a Liaison between UM and Quality and Care Management.
• Tracks data related to Performance Improvement activities; Assists with analysis of the data Reports trends and variances to Manager and Care Management Staff.
• Serves as a resource to Quality and Care Management staff to identify and implement actions to mitigate negative outcomes.
•  Assists the Manager as a clinical resource for coders and case management staff for documentation improvement program.
• Identifies educational needs and recommends and assists in education of medical staff, nursing and other involved staff concerning care management products/objectives/methods, which may include, but not limited to, length of stay, resource utilization, regulatory compliance and reimbursement issues
• Participates as an active member of Revenue Cycle Team and other teams as requested.
• Serves as an active member of Utilization Management Committee. Ensures that a strong relationship between all disciplines continues to grow with positive feedback for effective decisions.

Qualifications

Minimum Education :          

None specified; however, must be sufficient to meet the standards for achievement of the below indicated license and/or certification as required by the issuing authority.

Minimum Experience:         

Three (3) years of experience in case management with proven expertise in principles of quality and care management

Licensure Requirement:     

  Current Tennessee RN License.  Current certification in Case Management (CCM), Certification in Quality (CPHQ) or Case Management (ACMA) is preferred but not required.