Manager of Disease Management

Requisition Number 09-1290 Working Title Job Family Administrative Professional Salary Grade 47 Shift First Shift Department UMass Correctional Health Location South Street, 333 South Street City Shrewsbury State MA Hours/Week 40 Union Code W60 Summary of Position GENERAL SUMMARY OF POSITION:
The Manager, Disease Management, under the general supervision of the Chief Nursing Officer, is responsible for providing administrative and clinical case management as part of the UMass Correctional Health Program. This position is responsible for creating and implementing disease-specific clinical care protocols to ensure that inmates receive necessary care and to minimize hospitalizations, off-site trips, and maximize use of nurse and mid-level providers. As a member of a multidisciplinary team, the Manager, Disease Management is responsible for assessing, planning, organizing, reviewing, and evaluating the care needs of inmates with chronic diseases as outlined below. This position fosters and promotes continuity of care and cooperative partnerships by liaising with nursing and medical providers, acute care hospitals, and others involved in the provision of services. MINIMUM QUALIFICATIONS:
?RN licensed to practice in Massachusetts ? Bachelor's Degree in Nursing plus 5-10 years work experience or equivalent. ? 3-5 years related work experience providing direct service or case management to individuals with special needs, Certified Case Manager preferred. Experience with Word and Excel and other desktop tools. Position Description MAJOR RESPONSIBILITIES:
? Serve as the specialist in disease management for inmates with chronic diseases ? Act as an active participant of multi-disciplinary utilization and clinical management team meetings Participate in the Utilization Management program by providing case updates and participating in case discussion, transfer planning and quality of care issues. ? Review clinical information against appropriate criteria as dictated by the Correctional Health Utilization Management Plan ? Communicate with providers to obtain and clarify clinical information ? Determine the need for additional medical information ? Identify the need for referral to Associate Medical Director and/or Program Medical Director. ? Determine and authorize services for inmates in accordance with program guidelines and chronic disease protocols ? Develop and implement disease-specific and integrated inmate service plans ? Develop and implement disease-specific care protocols collaborating with and securing buy-in from medical leadership ? In conjunction with medical and nursing leadership, monitor and ensure compliance in administering protocols, and monitor inmate/patient compliance with clinical care and orders; ? Establish baseline measures and assess impact on utilization and clinical outcomes of implementing protocols; ? Collaboratively facilitate the care of patients with chronic diseases throughout the continuum of care. ? Facilitate communication between treatment facilities and correctional sites as appropriate to ensure continuity in following chronic disease treatment protocols and patient compliance. ? Work collaboratively with the Statewide Medical Director, Regional Directors and Clinical Administrators in assessing the appropriateness of implementing care protocols, managing that level of care and assuring the quality and competence of rendered care. ? Identify education needs and opportunities, and provide staff education related to chronic diseases, chronic disease care protocols in order to maximize consistency in care provision and patient compliance ? Develop audit criteria and provide oversight for periodic ad hoc reviews of inmate disease management services ? Evaluate and document the progress of inmate disease management services and make modifications, as required ? Travel statewide to Department of Correction Health Service Units and partner hospitals to evaluate on-going disease management initiatives and promote collaboration and communication between entities; ? Review medical records for compliance with chronic disease management plans ? In conjunction with UMCH senior and site leadership, promote compliance with correctional health accrediting bodies' policies and protocols ? Foster and promote continuity of care and cooperative partnerships by liaising with nursing and medical providers, acute care hospitals and other programs/organizations involved in the provision of services. ? Maintain positive working relationships with state correctional facility DOC and UMCH provider and site leadership and external providers of care and services ? Maintain the confidentiality of all business documents and correspondence. ? Participate in performance improvement initiatives and demonstrates the use of quality improvement in daily operations. ? Attend and participate in meetings, as required. ? Comply with established departmental policies, procedures and objectives. ? Comply with all health and safety regulations and requirements. ? Perform other duties and responsibilities as required. About UMASS UMASS CORRECTIONAL HEALTH UMass Correctional Health, a program of Commonwealth Medicine's Health and Criminal Justice (HCJ) Programs, provides comprehensive medical care services to over 10,000 incarcerated men and women at Massachusetts Department of Correction sites across the state. Facilities are located in eastern and central Massachusetts. Apply On-line Apply On-line Send to a Friend Send This Job to a Friend