Omaha Children's Hospital
Director, Care Coordination
Omaha Children's Hospital, Omaha, Nebraska, us, 68197
At Children’s, the region’s only full-service pediatric healthcare center, our people make us the very best for kids. Come cultivate your passion, purpose and professional development in an environment of excellence and inclusion, where team members are supported and deeply valued. Opportunities for career growth abound as we grow our services and spaces, including the cutting-edge Hubbard Center for Children. Join our highly engaged, caring team—and join us in providing brighter, healthier tomorrows for the children we serve. Children's is committed to diversity and inclusion. We are an equal opportunity employer including veterans and people with disabilities.
A Brief Overview
Responsible for developing and maintaining an enterprise-wide care management/care transitions system to include acute, episodic, primary care and lifelong health management. Aligns with clinical services to achieve the highest level of clinical outcomes and with Revenue Cycle to optimize financial outcomes. Ensures communication, collaboration and provision of clinical data and systems of care to support best practice outcomes. Integrates education, research and leadership to achieve quality outcomes and promote seamless care transitions that meet industry best practices. Provides oversight for care management across the care continuum.
Essential Functions
• Plans, implements, direct and evaluate care management functions on a strategic and operational level to support the CHMC strategic plan. Serves as subject matter expert regarding trends, best practices and innovations and identifies opportunities for their application. ◦ Collaborates with administration and the multidisciplinary team to ensure compliance with all regulatory requirements and operational initiatives regarding care management. ◦ Collaborates with Chief Revenue Officer to align clinical services with revenue capture and expense avoidance, including denials management, to achieve the highest level of clinical and financial outcomes. ◦ Actively participates in identifying emerging care delivery models, innovations and planning new care transition opportunities for Children’s. ◦ Researches population health delivery models and assists with development and implementation of care coordination processes and workflows within a pediatric health network. ◦ Develops the clinical interfaces to State programs, medical homes, community resources and providers. ◦ Works with key stakeholders to address any gaps in service and opportunities for improvement to achieve the highest level of clinical, quality and satisfaction outcomes. ◦ Defines, measures, analyzes, and improves key performance indicators to achieve the best possible outcomes. ◦ Understands the organization’s business environment (regulatory bodies, strategic alliances, etc.) and incorporates them into care management planning and system development. ◦ Leverages the use of clinical information technology, data analytics, predictive modeling, and decision-support tools in process and performance improvement related to patient care management and care transitions. ◦ Anticipates, understands and incorporates perspectives, expectations and concerns of customers into planning decision making and execution. ◦ Maintains a positive environment during the course of change. Energizes stakeholders and building a commitment to sustainable change.
• Supports the identification, development and implementation of protocols and pathways across the continuum including support for age transition programs. ◦ Develops and supports structures and processes to facilitate interdisciplinary care management for optimal care delivery across the enterprise including the development of a core group of clinical champions who advance the values of care transition across the enterprise. ◦ Develops and maintains relationships with community providers to improve patient access to care and develop transition of care processes. ◦ Ensures that external providers are consistent with the quality, cost, and patient satisfaction expectations of Children's and works with these providers to ensure access to a continuum of care for patients and their families. ◦ Identifies and implements solutions to barriers that impede the effective flow of care, across the continuum, for patients. ◦ Promotes organizational understanding of care management, disease management and wellness initiatives for at-risk populations.
• Responsible for managing all human resources functions for social work and case management. Motivates, mentors, and directs staff. Ensures that team members are held accountable individually and as a group for achieving optimal outcome. ◦ Personnel Management ▪ Selects/hires employees and oversees training on job related tasks. ▪ Conducts employee performance management duties including completion and delivery of performance evaluations, setting goals, dissemination of information, coaching, addressing performance issues/routine correction actions, and recommending termination of employment. ▪ Makes salary recommendations. ▪ Submits notifications for personnel actions (e.g., status changes, terminations). ▪ Determines human resource needs. ◦ Operational/Financial Management ▪ Participates in the development and implementation of strategic objectives for the division. ▪ Develops and implements business plans for the department(s) that support the goals and strategies of the organization. ▪ Defines and approves processes and procedures within the department(s). ▪ Develops and recommends policies related to the operational or functional area. ▪ Develops the annual budget for the operational or functional area including human resource needs. Prepares budget variance reports and develops corrective strategies to meet the area’s operational or financial plan. ▪ Applies business and management expertise to set direction, measure results, resolve problems, and achieve operational and financial objectives. ▪ Ensures compliance with quality assurance, safety practices, policies, regulatory, and legal requirements.
Education Qualifications
Bachelor's Degree in Nursing or Social Work Required and
Master's Degree from an accredited college or university in healthcare administration, nursing administration or related field Required
Experience Qualifications
Minimum 5 years of previous relevant experience required with 3 years supervisory/management experience Required
Skills and Abilities
Knowledge of hospital operations, billing, collection and reimbursement requirements and standard practices.
Ability to review, interpret and implement managed care contracts with third-party including governmental payers.
Foster creativity, innovation and divergent thinking in self and others.
Ability to communicate effectively both verbally and in writing to individuals and groups in a variety of settings.
Critical thinking, strategic and project management skills.
Ability to effectively implement change.
Customer focus.
Demonstrated leadership and management skills.
Licenses and Certifications
LCSW- Licensed Clinical Social Worker Upon Hire Required or
RN - Registered Nurse - State Licensure and/or Compact State Licensure Upon Hire Required and
Certification in case management, utilization management or other related field Preferred
Children’s is the very best for kids and the very best for your career! At Children’s, we put YOU first so together, we can improve the life of every child!
Requisition ID: 21817
A Brief Overview
Responsible for developing and maintaining an enterprise-wide care management/care transitions system to include acute, episodic, primary care and lifelong health management. Aligns with clinical services to achieve the highest level of clinical outcomes and with Revenue Cycle to optimize financial outcomes. Ensures communication, collaboration and provision of clinical data and systems of care to support best practice outcomes. Integrates education, research and leadership to achieve quality outcomes and promote seamless care transitions that meet industry best practices. Provides oversight for care management across the care continuum.
Essential Functions
• Plans, implements, direct and evaluate care management functions on a strategic and operational level to support the CHMC strategic plan. Serves as subject matter expert regarding trends, best practices and innovations and identifies opportunities for their application. ◦ Collaborates with administration and the multidisciplinary team to ensure compliance with all regulatory requirements and operational initiatives regarding care management. ◦ Collaborates with Chief Revenue Officer to align clinical services with revenue capture and expense avoidance, including denials management, to achieve the highest level of clinical and financial outcomes. ◦ Actively participates in identifying emerging care delivery models, innovations and planning new care transition opportunities for Children’s. ◦ Researches population health delivery models and assists with development and implementation of care coordination processes and workflows within a pediatric health network. ◦ Develops the clinical interfaces to State programs, medical homes, community resources and providers. ◦ Works with key stakeholders to address any gaps in service and opportunities for improvement to achieve the highest level of clinical, quality and satisfaction outcomes. ◦ Defines, measures, analyzes, and improves key performance indicators to achieve the best possible outcomes. ◦ Understands the organization’s business environment (regulatory bodies, strategic alliances, etc.) and incorporates them into care management planning and system development. ◦ Leverages the use of clinical information technology, data analytics, predictive modeling, and decision-support tools in process and performance improvement related to patient care management and care transitions. ◦ Anticipates, understands and incorporates perspectives, expectations and concerns of customers into planning decision making and execution. ◦ Maintains a positive environment during the course of change. Energizes stakeholders and building a commitment to sustainable change.
• Supports the identification, development and implementation of protocols and pathways across the continuum including support for age transition programs. ◦ Develops and supports structures and processes to facilitate interdisciplinary care management for optimal care delivery across the enterprise including the development of a core group of clinical champions who advance the values of care transition across the enterprise. ◦ Develops and maintains relationships with community providers to improve patient access to care and develop transition of care processes. ◦ Ensures that external providers are consistent with the quality, cost, and patient satisfaction expectations of Children's and works with these providers to ensure access to a continuum of care for patients and their families. ◦ Identifies and implements solutions to barriers that impede the effective flow of care, across the continuum, for patients. ◦ Promotes organizational understanding of care management, disease management and wellness initiatives for at-risk populations.
• Responsible for managing all human resources functions for social work and case management. Motivates, mentors, and directs staff. Ensures that team members are held accountable individually and as a group for achieving optimal outcome. ◦ Personnel Management ▪ Selects/hires employees and oversees training on job related tasks. ▪ Conducts employee performance management duties including completion and delivery of performance evaluations, setting goals, dissemination of information, coaching, addressing performance issues/routine correction actions, and recommending termination of employment. ▪ Makes salary recommendations. ▪ Submits notifications for personnel actions (e.g., status changes, terminations). ▪ Determines human resource needs. ◦ Operational/Financial Management ▪ Participates in the development and implementation of strategic objectives for the division. ▪ Develops and implements business plans for the department(s) that support the goals and strategies of the organization. ▪ Defines and approves processes and procedures within the department(s). ▪ Develops and recommends policies related to the operational or functional area. ▪ Develops the annual budget for the operational or functional area including human resource needs. Prepares budget variance reports and develops corrective strategies to meet the area’s operational or financial plan. ▪ Applies business and management expertise to set direction, measure results, resolve problems, and achieve operational and financial objectives. ▪ Ensures compliance with quality assurance, safety practices, policies, regulatory, and legal requirements.
Education Qualifications
Bachelor's Degree in Nursing or Social Work Required and
Master's Degree from an accredited college or university in healthcare administration, nursing administration or related field Required
Experience Qualifications
Minimum 5 years of previous relevant experience required with 3 years supervisory/management experience Required
Skills and Abilities
Knowledge of hospital operations, billing, collection and reimbursement requirements and standard practices.
Ability to review, interpret and implement managed care contracts with third-party including governmental payers.
Foster creativity, innovation and divergent thinking in self and others.
Ability to communicate effectively both verbally and in writing to individuals and groups in a variety of settings.
Critical thinking, strategic and project management skills.
Ability to effectively implement change.
Customer focus.
Demonstrated leadership and management skills.
Licenses and Certifications
LCSW- Licensed Clinical Social Worker Upon Hire Required or
RN - Registered Nurse - State Licensure and/or Compact State Licensure Upon Hire Required and
Certification in case management, utilization management or other related field Preferred
Children’s is the very best for kids and the very best for your career! At Children’s, we put YOU first so together, we can improve the life of every child!
Requisition ID: 21817