Assistant Director of Case Management

**ABOUT ADOBE **

Adobe Population Health (APH) is a women-owned health solutions company founded in 2018 with a mission of positively impacting the lives we touch. Headquartered in Phoenix, AZ, with satellite locations across multiple states, APH fosters a culture rooted in inclusivity, human kindness, and high-quality care.

Recognized by Inc. 5000 as one of America's Fastest-Growing Private Companies and honored five consecutive years as a " Best Place to Work" by the Phoenix Business Journal , APH continues to expand its reach and impact.

APH partners with health plans, providers, hospitals, and families to deliver tailored programs including case management, in-home and in-clinic wellness assessments, preventative care, transitional care, and social services. As one of the nation's few fully integrated healthcare organizations, APH delivers comprehensive, coordinated medical and social support through a wide range of specialized service lines.

With continued growth on the horizon, APH is seeking mission-driven individuals who are passionate about improving health outcomes and supporting those in need.

POSITION PURPOSE

The Assistant Director of the RN Case Managers is responsible for a reduced number of assigned members in assessing patient/family psychosocial needs, planning, implementing, procuring services for, and evaluating care needs. Goal focus on improving quality of life and health literacy. Coordinates, monitors, and ensures that appropriate and timely primary, acute and long-term care services are provided to members across the continuum of care. Promotes effective healthcare utilization, monitors health care resources, and assumes a leadership role within the Interdisciplinary Care Team (ICT) to achieve optimal clinical and resource outcomes for member. Coordinates the care and services of

selected member populations across the continuum of illness. Promotes effective utilization and monitors health care resources. Assumes a leadership role within the interdisciplinary team to achieve optimal clinical and resource outcomes. Works directly with the member in the field, i.e., inpatient bedside, member's home, provider's office, hospitals, etc. while collaborating with management to assess, plan, implement, coordinate, monitor and evaluate services and outcomes to maximize the health of the member. Additionally, this Manager is responsible for providing new employment orientation for RN Case Managers, assisting with on-going training for established RN Case Managers. The training, document

management, coordination of the orientation schedule is also included. The Manager will work collaboratively with the Director of Case Management to develop clinical processes and provide instruction to RN Case Managers.

DUTIES & RESPONSIBILITIES

RN Case Management (Estimated 50% case load):

• Evaluates members for case management services and determines appropriate level of care coordination/ management services for member.
• Completes a comprehensive assessment and develops a care plan utilizing clinical
• expertise to evaluate the members need for alternative services.
• Acts as a primary case manager for members identified as Complex as defined by Case Management Program Description.
• Acts a primary case manager for all assigned SNP members.
• Develops and monitors members plan of care, to include progress toward meeting established goals and self-management activities.
• Interacts continuously with member, family, physician(s), and other providers utilizing clinical knowledge and expertise to determine medical history and status. Assess the options for care including use of benefits and community resources to update the care plan.
• Supervises and/or acts as a resource for staff (i.e., Care navigators and LPN case managers).
• Acts as liaison and member advocate between the member/family, physician and facilities/agencies.
• Maintains accurate records of case management activities in the EMR using clinical guidelines.
• Coordinates community resources, with emphasis on medical, behavioral, and social services.
• Applies case management standards, maintains HIPAA standards and confidentiality of protected health information and reports critical incidents and information regarding quality-of-care issues.
• Ensures compliance with all state and federal regulations as well as corporate guidelines in day-to-day activities.
• Meets with clients in their homes, physician's offices, or hospitals to provide management of services.
• Adapts to changes in policies, procedures, new techniques, and additional responsibilities.
• Participates with other Case Managers and Medical Directors in regular or special meetings such as Clinical rounds.

Management of RN Case Managers

• Coordinates the on-boarding process for all new RN Case Managers to include scheduling of orientation, development of training schedule, coordination of other RN Case Managers to assist with orientation (prn), maintaining new hire training materials, and collaboration with Director on post training follow up.
• Provide information and assistance for NPI application.
• Collaborate with Director on work process development and roll out to RN CM team.
• Collaborate with Director for ICT coordination and oversight prn.
• Provide ongoing training updates based on identified needs of RN CM team.
• Collaborate on yearly RN CM performance evaluations.
• Performs other related duties as assigned by management.

Additional Responsibilities

• Assisting in the recruitment, orientation, training, and development of staff Supervises and evaluates the work of employees.
• Handling other related functions as necessary.
• Compliance with all HIPAA regulations.
• Travel to inpatient bedside, member's home, provider's office, hospitals, etc.
• Performs other related duties as assigned by management.
• This job description in no way states or implies that these are the only duties to be performed by this employee. He or she will be required to follow any other instructions and to perform any other duties requested by his or her supervisor, within the level of training or scope of practice.

SKILLS & QUALIFICATIONS

• A minimum of 2 years of experience in healthcare quality management, compliance, or a similar case management role.
• In-depth knowledge of healthcare regulations, accreditation standards, and quality improvement methodologies.
• Directly supervises 15+ RN Case Managers within the Case Management department.
• Works collaboratively with other ADCM and DCM to meet and exceed departmental goals.
• Carries out supervisory responsibilities in accordance with the organization's policies and applicable laws.
• Responsibilities include interviewing, hiring, and training employees; planning, assigning, and directing work; appraising performance; rewarding and disciplining employees; addressing complaints and resolving problems.
• Computer skills required: Microsoft Office Suite

EDUCATION, LICENSES, & CERTIFICATION

• Bachelor's degree in Healthcare Administration, Nursing, Medicine, or a related field required.
• Master's degree in Healthcare Administration, Nursing, Medicine, or a related field preferred.
• Current Arizona Nursing License.
• Certified Case Manager (CCM) certification required within 2 years of hire.

BENEFITS & TOTAL REWARDS

• Paid Onboarding and Training
• Insurance - Medical, Dental, Vision, and Life
• 401k Plan - 3% match
• Employee Assistance Program
• Tuition Reimbursement
• Continued Education Support
• Mileage Reimbursement (if applicable)
• Referral Bonuses
• Paid Holidays (9 days)
• Paid Time Off (15 days)
• Paid Volunteer Hours

CHARACTER & COMPETENCIES

• Courage - To have the courage to the right thing at the right time.
• Ownership - To take ownership of every issue you touch.
• Respect - To respect yourself, co-workers, and for those whom you care.
• Excellence - To be excellent in all that you do.
• Diversity - Demonstrates knowledge of EEO policy; Shows respect and sensitivity for cultural differences; Educates others on the value of diversity; Promotes a harassment-free environment; Builds a diverse workforce.
• Ethics - Treats people with respect; Keeps commitments; Inspires the trust of others; Works with integrity and ethics; Upholds organizational values.
• Adaptability - Adapts to changes in the work environment; Manages competing demands; Changes approach or method to best fit the situation; Able to deal with frequent change, delays, or unexpected events.
• Customer Service - Manages difficult or emotional customer situations; Responds promptly to customer needs; Solicits customer feedback to improve service; Responds to requests for service and assistance; Meets commitments.
• Interpersonal Skills - Focuses on solving conflict, not blaming; Maintains confidentiality; Listens to others without interrupting; Keeps emotions under control; Remains open to others' ideas and tries new things.
• Judgement - Displays willingness to make decisions; Exhibits sound and accurate judgment; Supports and explains reasoning for decisions; Includes appropriate people in decision-making process; Makes timely decisions.
• Problem-Solving - Identifies and resolves problems in a timely manner; Gathers and analyzes information skillfully; Develops alternative solutions; Works well in group problem-solving situations; Uses reason even when dealing with emotional topics.
• Professionalism - Approaches others in a tactful manner; Reacts well under pressure; Treats others with respect and consideration regardless of their status or position; Accepts responsibility for own actions; Follows through on commitments.
• Teamwork - Balances team and individual responsibilities; Exhibits objectivity and openness to others' views; Gives and welcomes feedback; Contributes to building a positive team spirit; Puts success of team above own interests; Able to build morale and group commitments to goals and objectives; Supports everyone's efforts to succeed.

PHYSICAL DEMANDS & WORK ENVIRONMENT

• Occasionally required to travel to meet with members or providers.
• Occasionally required to stand.
• Occasionally required to walk.
• Continually required to sit.
• Occasionally required to climb, balance, bend, stoop, kneel, or crawl.
• Continually required to talk or hear.
• While performing the duties of this job, the noise level in the work environment is usually moderate.
• May occasionally lift and /or move more than 30 pounds.
• Must be able to physically perform the essential duties of the position which include lifting 30 lbs., transporting materials, stooping, kneeling, crouching, reaching, use of hands, balancing, walking, standing, talking, hearing, and typing.

EQUAL EMPLOYMENT OPPORTUNITY

APH is an Equal Opportunity Employer where all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.