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AVP, Care Coordination

2 months ago

winstonsalem, United States Atrium Health Wake Forest Baptist Full time

Position: AVP of Care Coordination

Facility: Atrium Health Wake Forest Baptist System

Location: Winston-Salem, North Carolina

Relocation: Executive relocation firm provided


ABOUT WAKE FOREST:

Atrium Health Wake Forest Baptist is a pre-eminent academic health system based in Winston-Salem, North Carolina. Atrium Health Wake Forest Baptist is part of Advocate Health, which is headquartered in Charlotte, North Carolina, and is the third largest nonprofit health system in the United States, created from the combination of Atrium Health and Advocate Aurora Health.


Atrium Health Wake Forest Baptist’s two main components are an integrated clinical system – anchored by Atrium Health Wake Forest Baptist Medical Center, an 885-bed tertiary-care hospital in Winston-Salem – that includes Atrium Health Levine Children's Brenner Children’s Hospital, five community hospitals, more than 300 primary and specialty care locations and more than 2,700 physicians; and Wake Forest School of Medicine, the academic core of Atrium Health Enterprise and a recognized leader in experiential medical education and groundbreaking research that includes Wake Forest Innovations, a commercialization enterprise focused on advancing health care through new medical technologies and biomedical discovery.


HOW YOU WILL MAKE AN IMPACT:

As the AVP of Care Coordination you will be responsible for planning, managing, directing and evaluating the activities, functions, and personnel of the Care Coordination program across the Atrium Health Wake Forest Baptist (AHWFB) system. The AVP is responsible for developing and implementing standardized tools, roles and systems to support Care Coordination Services inclusive of case management, social work and utilization review; and for establishing the metrics and achieving targets for care coordination services to meet regulatory requirements, system goals, and respective local campus goals.


The AVP creates vision, strategy, structure and standardization of leading practice care coordination services across the health system to achieve clinical and operational excellence, and to support organizational financial sustainability. You will have responsibility for ensuring that care coordination initiatives and programs are coordinated with the department of transitional and supportive care and with the organization’s population health initiatives; and will provide direct leadership for utilization management resources and be responsible for authorization of services, clinical denials functions, and progression of care.


The AVP will perform duties and responsibilities in such a manner as to promote interpersonal relationships that engage stakeholders, and that drive and support change. This includes working collaboratively with medical and advanced practice provider staff, nursing staff, service line leaders, patient financial services, system and campus executive leadership, and local care management staff.

Essential Functions:

  • Exemplifies the WFBH Standards of Behavior and Code of Conduct, while striving to identify compliance risk through department led risk assessments, system monitoring, and periodic audits, and reporting any identified violation to Legal Services and Corporate Compliance Departments. Ensures immediate action is taken on any issues identified through a self-assessment or by Legal Services or Corporate Compliance; that policies are developed or revised as necessary; and that efforts are made to ensure a positive and compliant work environment for all employees.
  • Directs the activities, functions and management of personnel and of the program across the system to ensure that quality, age/developmentally appropriate care is provided according to the WFBH mission, departmental objectives and all internal/external regulations, policies and procedures.
  • Ensures a consistent effort toward quality improvement, employee engagement, patient-centered care, and customer satisfaction. Leads operational improvements that facilitate standardization of care management services across the organization and across the continuum of care, directly or through the influence of others at the system, service line, or local level.
  • Develops and participates in clinical management projects to ensure effective, efficient care that is responsive to patient care needs with measurable quality outcomes. Coordinates system-wide reporting of metrics and outcomes, holding associates accountable for accurate and timely data submissions. Analyzes and interprets data to direct improvement efforts.
  • Incorporates and integrates related theories, evidence, practice standards and other established knowledge into standardized processes and functions, applying current leading practice trends where applicable.
  • Establishes and maintains strategies that facilitate the transition of care delivery for patients with multiple provider agencies or network settings.
  • Promotes effective clinical management, communication and collaboration with members of inter- disciplinary team.
  • Contributes to the ongoing refinement of the strategic plan for case management services, identifying resources needed, risks and contingency plans.
  • Oversees compliance with regulations, laws and ethics via audits and direct observation.
  • Develops a network of care coordination colleagues across the country to maintain awareness of ongoing regulatory and legislative changes and methods to maintain compliance, and to stay abreast of leading practice trends.
  • Establishes partnerships with executives, medical staff, chief nursing officers, chief medical officers, patient financial services, and other key leaders across the health system related to care coordination, post-acute services, service affiliations and joint ventures.
  • Participates in review of organizational system contracts for issues pertaining to denials management, timelines for authorization of services, and other case management-related agreements.
  • Maintains a working knowledge of applicable federal, state and local laws/regulations as well as other compliance requirements (e.g. The Joint Commission, WFBH Conflict of Interest policies, etc.).


WHAT YOU WILL NEED:

Licensure, Registration, and/or Certification Required:

  • RN or MSW

Education Required:

  • Master’s degree in nursing or social work required.
  • Master’s degree in related health or business field desirable (MHA, MBA).

Experience Required:

  • Eight years of progressive acute care management leadership experience in an integrated, multi-campus health system, preferably with an academic medical center.
  • Experience in strategic planning and program development at a system level preferred.
  • Working knowledge of chronic conditions, evidence-based guidelines, prevention and wellness.
  • Able to develop chronic disease management strategies and appropriate protocols and guidelines.
  • Demonstrated program/project management and data analysis skills in population health management including population health analytics and disease management, and financial optimization.
  • Experience in developing education curriculum and programs for care management
  • Solid working knowledge of managed care and governmental payment policies

Work Environment:

  • Teamwork – Is an effective team player who adds complementary skills and contributes valuable ideas, opinions and feedback. Communicates in an open and candid manner and can be counted upon to fulfill any commitments made to others on the team to promote a positive work environment.
  • Compassion- Genuinely cares about people and is available and ready to help. Shows sincere concern and empathy and accepts differences.
  • Integrity – Views self as a reflection of the organization by following through on commitments and accepting ownership of any mistakes.

Physical Requirements and Working Conditions:

  • Operates all equipment necessary to perform the job.


This job description indicates the general nature and level of work expected of the incumbent. It is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities required of the incumbent. Incumbent may be required to perform other related duties.


About Advocate Health

Advocate Health is the third-largest nonprofit, integrated health system in the United States, created from the combination of Advocate Aurora Health and Atrium Health. Providing care under the names Advocate Health Care in Illinois; Atrium Health in the Carolinas, Georgia and Alabama; and Aurora Health Care in Wisconsin, Advocate Health is a national leader in clinical innovation, health outcomes, consumer experience and value-based care. Headquartered in Charlotte, North Carolina, Advocate Health services nearly 6 million patients and is engaged in hundreds of clinical trials and research studies, with Wake Forest University School of Medicine serving as the academic core of the enterprise. It is nationally recognized for its expertise in cardiology, neurosciences, oncology, pediatrics and rehabilitation, as well as organ transplants, burn treatments and specialized musculoskeletal programs. Advocate Health employs 155,000 teammates across 69 hospitals and over 1,000 care locations, and offers one of the nation’s largest graduate medical education programs with over 2,000 residents and fellows across more than 200 programs. Committed to providing equitable care for all, Advocate Health provides more than $6 billion in annual community benefits.