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MemorialCare

Executive Director Corporate Care Coordination

MemorialCare, Fountain Valley, California, us, 92728


Title:

Executive Director, Care CoordinationLocation:

Fountain Valley, CADepartment:

AdministrationStatus:

Full-timeShift:

DaysPay Range:

168k - 231kMemorialCare is a nonprofit integrated health system that includes four leading hospitals, award-winning medical groups - consisting of over 200 sites of care, and more than 2,000 physicians throughout Orange and Los Angeles Counties. We are committed to increasing access to patient-centric, affordable, and high-quality healthcare; your personal contributions are integral to MemorialCare's recognition as a market leader and innovator in value-based and other care models.Across our family of medical centers, we support each one of our bright, talented employees in reaching the highest levels of professional development, contribution, collaboration, and accountability. Whatever your role and whatever expertise you bring, we are dedicated to helping you achieve your full potential in an environment of respect, innovation, and teamwork.Position SummaryThe Executive Director of Care Coordination has responsibility and oversight for the system Case Management and Social Work Service programs within hospital services and MCMF, guiding operational and clinical issues for high quality, cost effective, integrated processes in support of patient care while maximizing the revenue cycle. The incumbent establishes strategic and results oriented tactics, goals and objectives using a collaborative, team approach to deliver excellent patient experience, safety and care progression that is fiscally responsible and meets current and anticipated needs of the community served. The incumbent is responsible for building relationships and creating partnerships with community organizations to build programs and resources.The Executive Director of Care Coordination ensures systems and processes are in place to support regulatory and accreditation compliance with state and federal regulations as well as related accrediting bodies for all programs within the scope of the assigned departments and services are within the defined span of control.The Executive Director of Care Coordination is accountable for human and material resource acquisition, quality/performance improvement outcomes to maximize patient throughput, utilization management, authorization and billing process to enhance outcomes, and readmission prevention. This role will assist with Utilization Management Committee key metrics including length of stay, authorization related key performance indicators, referral delays, and care progression. The success of the departments depends significantly on the incumbent's ability to collaborate with other leaders across the health system to develop and maintain systems that support patient care through care coordination strategies and revenue cycle improvements.Principal Duties and Responsibilities:

Briefly describe the major responsibilities and functions of this position.Develop and execute a comprehensive strategy for care coordination, case management, and help coordinate utilization management that aligns with the healthcare system's mission, vision, and goals.Lead and manage a multidisciplinary team of case managers/care coordinators, and social workers ensuring effective team performance and professional development.Design, implement, and monitor system and standardized programs to improve patient transitions across the continuum of care, reducing readmissions and enhancing patient outcomes.Collaborate with clinical leadership, physicians, and external partners to integrate care management/coordination and utilization management activities and promote best practices.Establish and maintain policies, procedures, and standards for care coordination and case management that meet regulatory and accreditation requirements.Analyze and utilize data to identify opportunities for improvement, measure program effectiveness, and report outcomes to executive leadership.Drive initiatives to enhance patient and family engagement, ensuring culturally competent care and addressing social determinants of health.Oversee budget planning and financial management for care coordination services, ensuring cost-effective operations.Serve as a subject matter expert and advocate for care coordination and case management within the healthcare system and in the broader community.Minimum RequirementsQualifications/Work Experience:Licensed health care professional with a minimum of 5 years of management experience of case management and/or utilization management in an acute care hospital setting, including clinical operations.Education/Licensure/Certification:Bachelor's degree required.Active, unrestricted State Registered Nursing (RN) license in good standing.Accredited Case Manager Certification (ACM or CCM), Utilization Management Certification (CPHM) Certified Professional in Health Care Quality (CPHQ) or other healthcare or management certification.

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