Outcome Specialist Care Manager

General Description: Under general supervision, the Outcome Specialist in Care Management performs professional work in the coordination, evaluation, and improvement of patient care outcomes. The Outcome Specialist develops and leads staff training programs to enhance the competency and performance of evidence-based practice for the case managers and other clinical staff. This role collaborates with interdisciplinary teams, facilitates discharge planning, and ensures compliance with quality standards and regulatory requirements. This role is crucial in driving performance improvement within the hospital's case management department, ensuring that patients receive timely, efficient, and high-quality care across the continuum. The Outcome Specialist's contribution directly impacts patient safety, satisfaction, and organizational success.

Essential Responsibilities: The core responsibilities of this position are critical to its success. Inability to perform these responsibilities with or without accommodation may result in disqualification from the role.

• Planning, Implementation, and Evaluation of Care Coordination Programs: Responsible for organizing and executing comprehensive patient care programs that improve health outcomes, focusing on both short- and long-term goals.
• Quality and Outcome Improvement Initiatives: Coordinates and facilitates ongoing quality improvement projects and assesses the effectiveness of case management activities to ensure high standards of care. Analyzes patient data to identify trends and implement solutions for optimal patient outcomes.
• Staff Development & Training: Develops, coordinates, and evaluates staff development and training initiatives, ensuring all personnel are proficient in evidence-based care practices and competent in patient care skills. Conducts competency verification, particularly in areas related to case management and patient discharge planning.
• Patient Discharge and Continuum of Care Planning: Works with the interdisciplinary team to coordinate safe and efficient discharge plans for patients, ensuring smooth transitions across care settings. Provides guidance and oversight in the development of care plans that consider cultural, age-appropriate, and individual patient needs.
• Outcome Evaluation & Data Analysis: Utilizes clinical data and outcome metrics to evaluate the effectiveness of hospital case management programs. Develops criteria to assess patient care outcomes, documenting program success and areas for improvement.
• Collaboration and Interdisciplinary Team Engagement: Serves as a liaison between nursing, medical staff, social work, and other departments to ensure seamless patient transitions and adherence to quality care standards.
• Compliance and Regulatory Oversight: Ensures that hospital care programs meet Joint Commission, CMS, and other regulatory standards. Maintains up-to-date knowledge of applicable healthcare policies and works to integrate them into hospital care processes.
• Preceptor Program: Plans, implements, and evaluates the hospital's Preceptor Program, fostering the professional development of new staff members and ensuring ongoing support and mentorship for nursing staff.
• Performs other duties as assigned.

Minimum Qualifications:

Education:

• RNs: Graduate of an accredited school of nursing required. Bachelor of Science in Nursing (BSN) preferred.
• Social Workers: Graduate of an accredited school of social work. License Master Social Worker (LMSW) under supervision or Licensed Clinical Social Worker (LCSW) required.

Experience: Minimum of three (3) years of experience in case management, hospital discharge planning, or a related area in nursing practice.

Licensure/Certification:

• Certification in Case Management (CCM) or Certified Professional in Healthcare Quality (CPHQ) highly preferred.
• RNs: Current Registered Nurse (RN) License issued by the Oklahoma State Board of Nursing, or a current multistate compact RN License (eNLC).
• Social Workers: Current Licensed Clinical Social Worker or License Master Social Worker issued by the Oklahoma State Board of Licensed Social Workers and under supervision.

Knowledge, Skills, and Abilities:

• Strong clinical knowledge with expertise in care coordination and patient outcomes management.
• Excellent communication and presentation skills for staff development and interdisciplinary collaboration.
• Knowledge of regulatory standards and compliance related to hospital care management (e.g., TJC, CMS).
• Strong teaching and mentoring abilities to guide staff development.
• Ability to analyze clinical data and develop targeted improvement initiatives.
• Competency in utilizing electronic health records and case management software.
• Innovative in program development and able to work independently when designing training and care protocols.
• Skill in reading and applying clinical research to practice improvement.