Manager of Professional Practice and Compliance; LCSW or RN

A Brief Overview

The Manager of Professional Practice and Compliance ensures the provision of quality patient care by ensuring the clinical competence of Case Managers, Social Workers, Complex Case Managers, Support Liaisons, and Utilization/Denials & Appeals. This individual works collaboratively with managers, directors, content experts and educators throughout the organization, to develop, deliver, and evaluate education and training for staff. Responsibilities include developing and implementing orientation, in-services, and continuing education programs, utilizing current evidence‑based practices while focusing on the knowledge and skills required to care for patients.

Serves as an influential leader, role model, and consultant for clinical and educational practices. This individual will consult with managers and staff regarding patient care issues, staff performance, and participate in setting standards for clinical practice. This clinician will ensure the department is in compliance with accreditation and licensing requirements and maintain oversight with department policies. This position serves as a resource for problem solving, performance improvement, policy implementation and staff issues.

Responsibility for the interpretation of data related to social work and case management and delivery of interventions.

Stanford Health Care

• Promotes individual professional growth and development by meeting requirements for mandatory/continuing education, skills competency, supports department-based goals which contribute to the success of the organization; ensures each role is working at top of license; serves as preceptor, mentor, and resource to less experienced staff.
• Analyzes training needs based on system changes and recommends appropriate training solutions.
• Identifies, plans, develops, implements, coordinates, and evaluates education programs, interacting with staff to ensure needs are met.
• Collaborates with other departments, managers, and physicians to continuously improve care coordination and integrates services within the department and the hospital.
• Develops and implements policies that guide and support the provision of services in line with the mission and goals of SHC; ensures that policies and procedures meet both internal and the external regulatory and statutory requirements. Ensures compliance with State Mandated Reporting Policies and Procedures and program accreditation requirements pertaining to Social Work/Case Management department staff.
• Support the integration of the department's services with the hospital's primary functions by supporting organizational mission, priorities and goals, and by delivering optimal quality health care services.
• Maintains an openness to change and fosters that attitude with peers, staff, physicians, and committee members. Maintains a focus on both the operational details and larger strategic vision in order to effectively move toward completion and positive outcomes.
• Assists Directors in evaluation of processes and procedures that would ensure compliance with regulatory standards.
• Prepares department for accreditation surveys, monitors, and assures compliance with hospital policy and regulatory standards.
• Identifies learning needs and education gaps for the Social Work / Case Management department and works collaboratively with managers to implement education.
• Takes accountability for projects and/or other assignments as assigned by the Department Directors and plans, coordinate, and administers activities as appropriate.

• Bachelor’s Degree in Nursing from an accredited college or university and/or Master’s Degree in Nursing from an accredited college or university required OR
• Master's degree in Social Work (MSW) from an accredited college or university required

• Five (5) years of progressively responsible and directly related work experience required

• Knowledge of principles and best practices of case management, utilization review, social work, care coordination and discharge planning.
• Knowledge of managed care and commercial insurance, Medi…