Director – Care Coordination

Overview

The Director – Care Coordination is responsible for system-wide Care Coordination functions (Capacity Coordination, Social Work, Navigation, and Case Management) including the execution of the care coordination strategic plan for the health system and the health plan, which includes organizing and directing an integrated cross-continuum care management and transitions of care program that monitors (on both an individual case and aggregate level) and directs actions to ensure achievement of health system and health plan goals, initiation of change management processes, and implementation of best practices, policies, and procedures.

Responsibilities

Works closely with the VP, Care Coordination and Hospital Chief Nursing Officers to develop tactics that are aligned with current performance and vision for the care coordination program, including

Compliance with all CMS regulations

Assuring timely patient care progression

Appropriate care and resource utilization

Safe discharge planning

Synthesizing and applying data analytics to drive system care coordination performance

Collaborate with physicians and other departmental leaders and staff to ensure that barriers to care coordination outcomes are addressed timely. Attention should be given to identifying root causes and driving performance improvement initiatives that ensures performance is aligned to targeted goals, such as

Length of stay (LOS)

Avoidable days

Readmissions

Payer denials

Other care coordination related outcomes

Manage, interpret and share Care Coordination data with Dartmouth Health executives, department leaders, Care Coordination leaders and others, as needed

Personnel management and development

Play a key role in the professional development of Care Coordination leaders and staff, including mentoring and coaching

Collaborate with Care Coordination and Dartmouth Health system and local leaders to develop the department’s operational structure

Facilitate engagement with Care Coordination leaders at each DH system member to develop and implement standard roles and staffing models

Develop, revise and maintain standardized Care Coordination education and resource materials

Develop and implement professional standards for care coordination based upon recognized standards of care, JCAHO and CMS standards, state/federal regulations and overall system policies and procedures

Builds a culture of trust and engagement as reflected in the Great Place to Work Trust Index Survey at a direct report, workgroup and hospital/entity level

Policy, procedure and process development and ongoing ownership

Draft and recommend for final approval Care Coordination policies and procedures

Develop comprehensive resource guidelines and processes for complex patient management

Local, State and Federal collaboration and compliance

Monitor Hospital Care Coordination for consistent compliance of regulatory standards, including CMS Conditions of Participation

Represent Dartmouth Health Care Coordination at local, State, and national meetings through educational offerings and through involvement in professional organizations

Performs other duties as required or assigned.

Qualifications

Master’s degree in clinical or health related field required.

A minimum of five to seven years of leadership experience in care coordination, case management, or utilization review, in an integrated healthcare delivery system and/or health plan.

Nationally recognized certification preferred, i.e., Certified Professional in Healthcare Quality (CPHQ), Certified Case Manager (CCM), Certified Professional Utilization Management (CPUM), Certified Professional Utilization Review (CPUR), or Diplomat of American Board of Quality Assurance and Utilization Review Physicians (D-ABQAURP)

Strong leadership, communication, and computer skills desired

Extensive knowledge of payer mechanisms and clinical utilization management is required.

Possesses working knowledge of clinical systems, outcome measures, and processes required along with various patient information systems.

Knowledge and understanding of hospital information systems and their potential uses and benefits.

Possesses facility for data analysis and interpretation. Must be data driven with a passion for medical management. Possesses ability to organize and present data in a concise and easily understood manner to peers, physicians, and other stakeholders.

Required Licensure/Certifications

– Licensed Registered Nurse in New Hampshire required.

– Certified as an Accredited Case Manager, Certified Case Manager, or Case Management Administrator required

Area of Interest:

Nursing;

FTE/Hours per pay period:

1.00 – 1.00 – 40 hrs/week;

Shift:

Day;

Job ID:

25731;

Dartmouth Health is an Affirmative Action and Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, or protected veteran status and will not be discriminated against on the basis of disability.

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