Director, Care Management
1 month ago
Come work at the best place to give and receive care
The Director of Care Coordination is responsible for the execution of strategic development for Care Coordination across the healthcare system. The Director will develop effective and efficient systems and processes for care/utilization management, discharge planning/transition management, coordination of care in the ambulatory setting, social work services, interpreter services and pastoral care. In addition, they will oversee the collection, analysis, and reporting of financial and other data related to care coordination processes across the healthcare system. Specific focus will be allocated to the areas of utilization management, length of stay, denial trends, quality outcomes in the ambulatory setting, and the efficient use of and appropriate access to Interpreter services. The Director of Care Coordination will be accountable for achieving established performance targets through the use of continuous performance improvement techniques. The Director of Care Coordination will support and facilitate internal and external relationships and facilitate processes improvement to optimize relevant outcomes. The position requires a balance of evidence-informed clinical knowledge, strong business acumen and effective collaboration at the corporate, hospital, ambulatory practice and community levels with multi-disciplinary clinicians, senior administrators and executives.
Establish, implement and evaluate a strategic plan for the division that takes into account internal and external factors, follows industry best practices and prioritizes institutional goals
Facilitate the transition of patients/families across the continuum by establishing relationships (or overseeing the development of relationships) with appropriate providers and community services
Partner with clinical leadership to provide expertise and support to improve performance in payor designated quality outcomes and contractual obligations related to care coordination
In partnership with clinical leadership and CCE, develops tools that displays actionable critical outcome factors that focus on value (quality/cost) including utilization and quality metrics such as Length of Stay, readmissions, care gap closure rates and denial rates.
Review the findings with the Executive Team
Provide feedback and support redeployment of resource and workflows to optimize the Care Coordination sensitive data findings
Co-chair of the Utilization Management Oversight Committee
Establishes policies, procedures and protocols for departmental functions
Insures that the Utilization Management Plan is current and compliant with CMS and other regulations.
Creates a system for initial and ongoing education and development of staff
Ensure the provision of a functional system for initial and ongoing education and development of staff
Master’s Degree in Nursing, Business Administration, Health Administration, Social Work, or related field required
Strong clinical background, experience in care coordination, discharge planning and overall case management experience preferred.
Valid Nursing or LICSW credentials required. Nationally recognized care management certification preferred.
Health, dental, prescription, and vision coverage for full-time & part-time employees
~ Short-term disability, long-term disability, and life insurance coverage
~ Tuition Reimbursement
~403(b) Retirement Savings Plan
Work Shift:
Monday-Friday, Day Shift
SolutionHealth is an equal opportunity employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, disability status, veteran status, or any other characteristic protected by law.
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