Trinity Health
Interim Director – Case Management and Utilization Review
Trinity Health, Silver Spring, Maryland, United States, 20900
Employment Type:
Full time
Shift:
Description:
This is an Interim Position.
13 weeks
Compensation: $3400.00 weekly with travel paid.
Job Summary:
Develops, organizes and directs an integrated, hospital-wide care management program which monitors (on both an individual case and aggregate level) and directs action to ensure achievement of appropriate levels of Hospital resource utilization, including utilization, discharge planning, and care coordination. This function is achieved through concurrent data collection, analysis, and coordinated documentation and discharge focused activities. In order to implement this function, education, consultation, and guidance is provided to the Hospital’s caregiving staff, to the Medical staff, and to patients and family members.
Supervises the activities of hospital staff in inpatient care coordination, utilization review, social work, and discharge planning. Oversees interactions of staff with outside activities and agencies on regulations affecting patient status and insurance.
Works in close collaboration with the Medical Director of Care Management to implement the policies and programs of the Department. Works in close collaboration with the Director of Documentation Quality and Care Transitions related to denial prevention, readmission prevention, and Palliative Care.
Supports the Mission of Trinity Health and Holy Cross Hospital.
Minimum Licensure/Certification Required:
Masters level or higher education is required in a healthcare-related field (e.g., nursing, social work, healthcare administration, medicine).
Maintains licensure recognized by the state of Maryland if trained in a clinical specialty.
Minimum Knowledge, Skills, & Abilities Required:
Five years of experience in care management or related activity.
Extensive knowledge of payer mechanisms and clinical utilization management is required.
Minimum of 2 years leadership experience in case management, utilization review, or closely related area.
Demonstrated ability to establish and maintain effective interpersonal relationships with all levels of personnel, medical staff, and community, as well as a demonstrated ability to work effectively with interdisciplinary teams.
Knowledge of pertinent regulatory, accreditation, public and private service organizational activities relating to social services and resource utilization. Evidence of prior successful interaction with external review organizations.
Demonstrated ability to lead through collaboration and influence.
Reads, writes, speaks, and comprehends the English language.
Management Statement:
Management at Holy Cross Hospital involves understanding that we operate within a fiduciary relationship in which we are expected to steward our community’s resources in such a way that we produce high quality, safe, efficient, and effective care for both today’s patients and tomorrow’s patients. This enables us to become the most trusted provider of health services within our community.
A Director at Holy Cross Hospital is expected to demonstrate ethical behavior and support the mission of Holy Cross Hospital, while possessing and utilizing excellent analytical and monitoring skills, fiscal responsibility, and the ability to select, train and retain managers and line employees who are capable of creating a desirable work environment. Directors are expected to oversee 24-hour operations of their specific areas, ensuring the successful day-to-day function of the area, policy and objectives communication to staff, and that operational processes are staffed and monitored appropriately to ensure that quality, customer service, and financial performance are maintained.
Directors are responsible for establishing departmental policies and procedures and adapting them as necessary to meet operational objectives. Directors monitor their departmental results against budget, operational and strategic plans and determine how to improve performance against each. Effective cross-departmental cooperation and the ability to work with peers and senior management are essential for the director to obtain the necessary agreements and resources needed to meet both area-specific and organizational objectives.
Working Conditions:
Physical Requirements:
Light work. Exerting up to 20 pounds of force occasionally, and/or up to 10 pounds of force frequently, and/or a negligible amount of force constantly to move objects. Requires extensive use of keyboard and mouse.
Visual Acuity:
The worker is required to have close visual acuity to perform an activity such as: preparing and analyzing data and figures; transcribing; viewing a computer terminal; extensive reading.
Environmental Conditions:
The worker is subject to the typical hazards of office and inpatient medical environment. Is exposed to risk of transmission of infectious diseases.
Supervisory Responsibilities:
Oversees the entire operations of the Department of Care Management.
Assumes primary responsibility for the following direct reports:
Manager of Utilization Review and Case Management
Manager of Continuum of Care
Department Administrative Support Staff
Reporting Relationship:
Reports to and is evaluated by the Senior Director Care Management and Dialysis. Consults, on a regular basis, with the Vice President of Patient Care Services (Nurse Executive), the Vice President of Medical Affairs, the Vice President of Support Services, and the Chief Quality Officer.
Our Commitment to Diversity and Inclusion:
Trinity Health is one of the largest not-for-profit, Catholic healthcare systems in the nation. Built on the foundation of our Mission and Core Values, we integrate diversity, equity, and inclusion in all that we do. Our colleagues have different lived experiences, customs, abilities, and talents. Together, we become our best selves. A diverse and inclusive workforce provides the most accessible and equitable care for those we serve. Trinity Health is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, status as a protected veteran, or any other status protected by law.
00545478
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Full time
Shift:
Description:
This is an Interim Position.
13 weeks
Compensation: $3400.00 weekly with travel paid.
Job Summary:
Develops, organizes and directs an integrated, hospital-wide care management program which monitors (on both an individual case and aggregate level) and directs action to ensure achievement of appropriate levels of Hospital resource utilization, including utilization, discharge planning, and care coordination. This function is achieved through concurrent data collection, analysis, and coordinated documentation and discharge focused activities. In order to implement this function, education, consultation, and guidance is provided to the Hospital’s caregiving staff, to the Medical staff, and to patients and family members.
Supervises the activities of hospital staff in inpatient care coordination, utilization review, social work, and discharge planning. Oversees interactions of staff with outside activities and agencies on regulations affecting patient status and insurance.
Works in close collaboration with the Medical Director of Care Management to implement the policies and programs of the Department. Works in close collaboration with the Director of Documentation Quality and Care Transitions related to denial prevention, readmission prevention, and Palliative Care.
Supports the Mission of Trinity Health and Holy Cross Hospital.
Minimum Licensure/Certification Required:
Masters level or higher education is required in a healthcare-related field (e.g., nursing, social work, healthcare administration, medicine).
Maintains licensure recognized by the state of Maryland if trained in a clinical specialty.
Minimum Knowledge, Skills, & Abilities Required:
Five years of experience in care management or related activity.
Extensive knowledge of payer mechanisms and clinical utilization management is required.
Minimum of 2 years leadership experience in case management, utilization review, or closely related area.
Demonstrated ability to establish and maintain effective interpersonal relationships with all levels of personnel, medical staff, and community, as well as a demonstrated ability to work effectively with interdisciplinary teams.
Knowledge of pertinent regulatory, accreditation, public and private service organizational activities relating to social services and resource utilization. Evidence of prior successful interaction with external review organizations.
Demonstrated ability to lead through collaboration and influence.
Reads, writes, speaks, and comprehends the English language.
Management Statement:
Management at Holy Cross Hospital involves understanding that we operate within a fiduciary relationship in which we are expected to steward our community’s resources in such a way that we produce high quality, safe, efficient, and effective care for both today’s patients and tomorrow’s patients. This enables us to become the most trusted provider of health services within our community.
A Director at Holy Cross Hospital is expected to demonstrate ethical behavior and support the mission of Holy Cross Hospital, while possessing and utilizing excellent analytical and monitoring skills, fiscal responsibility, and the ability to select, train and retain managers and line employees who are capable of creating a desirable work environment. Directors are expected to oversee 24-hour operations of their specific areas, ensuring the successful day-to-day function of the area, policy and objectives communication to staff, and that operational processes are staffed and monitored appropriately to ensure that quality, customer service, and financial performance are maintained.
Directors are responsible for establishing departmental policies and procedures and adapting them as necessary to meet operational objectives. Directors monitor their departmental results against budget, operational and strategic plans and determine how to improve performance against each. Effective cross-departmental cooperation and the ability to work with peers and senior management are essential for the director to obtain the necessary agreements and resources needed to meet both area-specific and organizational objectives.
Working Conditions:
Physical Requirements:
Light work. Exerting up to 20 pounds of force occasionally, and/or up to 10 pounds of force frequently, and/or a negligible amount of force constantly to move objects. Requires extensive use of keyboard and mouse.
Visual Acuity:
The worker is required to have close visual acuity to perform an activity such as: preparing and analyzing data and figures; transcribing; viewing a computer terminal; extensive reading.
Environmental Conditions:
The worker is subject to the typical hazards of office and inpatient medical environment. Is exposed to risk of transmission of infectious diseases.
Supervisory Responsibilities:
Oversees the entire operations of the Department of Care Management.
Assumes primary responsibility for the following direct reports:
Manager of Utilization Review and Case Management
Manager of Continuum of Care
Department Administrative Support Staff
Reporting Relationship:
Reports to and is evaluated by the Senior Director Care Management and Dialysis. Consults, on a regular basis, with the Vice President of Patient Care Services (Nurse Executive), the Vice President of Medical Affairs, the Vice President of Support Services, and the Chief Quality Officer.
Our Commitment to Diversity and Inclusion:
Trinity Health is one of the largest not-for-profit, Catholic healthcare systems in the nation. Built on the foundation of our Mission and Core Values, we integrate diversity, equity, and inclusion in all that we do. Our colleagues have different lived experiences, customs, abilities, and talents. Together, we become our best selves. A diverse and inclusive workforce provides the most accessible and equitable care for those we serve. Trinity Health is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, status as a protected veteran, or any other status protected by law.
00545478
#J-18808-Ljbffr