A Brief Overview

Under direction of the Market Manager, Care Transitions and Rehab, the Supervisor of Care Transition will manage day to day operations of their site and/or area. The Supervisor will act in two capacities; the liaison between site and/or area leadership and the Care Transitions team and the content expert for all team clinical operations at their site (including TCC, PCN and SW).Supervisors will drive site specific metrics tied to Care Transitions including but not limited to NSOC, observation hours, length of stay, patient throughput, patient flow, readmission prevention efforts, follow up appointment obtainment and tracking as well as daily escalation of barriers. In addition, will focus on patient experience and staff engagement outcomes at their site and/or area.This role requires expert working knowledge of the roles and responsibilities of each team member and ability to be the content expert on all clinical operations for the Care Transitions team at their site and/or area.Collaborates with other disciplines at their site and/or area to maximum patient experience and throughput.

What You Will Do

• Day to day oversight and support of the Care Transitions team (TCC and SW).
• Collaboration with physicians, homecare ambassadors, post-acute facility liaisons, UM, ACO/Population Health to ensure a smooth transition of care for patients while utilizing in-network providers. Focus on connection to our UH and JV network providers.
• Identifying trends, outliers, functional/technical needs, and improvement strategies to decrease length of stay and increase patient experience.
• Monitoring metrics to track performance of Care Transitions team and the selection of the right next site of care.
• Identifying and escalating barriers in collaboration with site specific leadership.
• Providing guidance/consultation/escalation to team regarding complex psychosocial and/or discharge planning issues/barriers.
• Regular meetings with local hospital and/or area leadership and other key stakeholders to review key metrics and team performance. Participation in hospital committees as assigned.
• Monitors regulatory compliance with CMS: DNA, IMM letters, audits, ABN, HINN LONC, etc.
• Coordinates activities to ensure patient’s appeal rights under Notification of Hospital Appeal Rights. Including timely answers to KeyPro phone calls regarding appeals and guidance to team/patient/family regarding complex family appeals.
• Development of team; clinically and professionally by providing career development and coaching opportunities.
• Develops and maintains audit processes in alignment with CMS conditions of participation and UH specific policy.
• Develops and participates in special projects and system committees tied to Care Transitions metrics.
• Under the guidance of the Regional Manager, will conduct talent selection, provide operational and practice oversight, complete performance evaluations, provide a just culture during corrective action, and if needed complete team member termination for direct reports.
• Assists with recruitment, orientation, mentoring, on-boarding and connection of new staff to other professional colleagues.
• Oversight of guidelines, policies and processes specific to Care Transitions team.
• Coordinates daily schedule for Care Transitions team, ensuring coverage for patient care units/physician teams.
• Maintains competencies and licensure for staff members in collaboration with System Care Transitions Educator and Regional Manager.

Additional Responsibilities

• Performs other duties as assigned.
• Complies with all policies and standards.
• For specific duties and responsibilities, refer to documentation provided by the department during orientation.
• Must abide by all requirements to safely and securely maintain Protected Health Information (PHI) for our patients. Annual training, the UH Code of Conduct and UH policies and procedures are in place to address appropriate use of PHI in the workplace.