Wellstar Health System, Inc.
Director, Care Coordination
Wellstar Health System, Inc., Augusta, Georgia, United States, 30910
Facility: Wellstar MCG Health
Job Summary:
The Director of Care Coordination will work closely with the CMO, CFO and other members of the senior leadership team to build strategies that are aligned with current performance and hospital goals and vision for the care management program, timely patient throughput, appropriate care and utilization, safe disposition planning as well as utilizing data and analytics to drive departmental performance. The director will be responsible for adherence to the system Utilization Management Plan and care coordination policies and procedures, Care Coordination standards of care, CMS and other Payer regulations, Joint Commission regulations, and will ensure that the system strategic vision is fully integrated into the culture of the care coordination program. Will align closely with physician and share performance data with individual physicians and service lines.
The Director of Case Management is responsible for the day-to-day operations for all case management activities across the hospital, including utilization management, safe transitions planning, financial performance related to payer authorization processes, avoidable day tracking and reporting, medical necessity, ongoing quality, productivity and overall efficiency for case management processes. This director will ensure that the system standardize care coordination processes are implemented and followed always. As part of the role, the director will collaborate with physicians and other departmental leaders and staff to ensure that barriers to CM outcomes such as length of stay (LOS), avoidable days, readmissions, payer denials and other CM related outcomes are addressed timely with attention given to identifying root causes and driving performance improvement initiatives that ensures performance is aligned to targeted goals. Must be able to manage, interpret and share data.
Other duties of the director include creating and enhancing current tools, methodologies, recruiting practices, and personnel development processes. Plays a key role in the retention, professional development and performance review of staff, including mentoring, coaching, performance appraisals and recruiting as well as departmental budgets. The director participates in committees with the hospital medical staff and other leaders to address and solve issues that drive variation from goals. Is also responsible for collaborating with other key departments that drive throughput delays and work to jointly eliminate those barriers.
Required Minimum Education:
Bachelor's Nursing or Master's Social Work required.
Master's Public Health - Preferred
Master's Health Administration - Preferred
Required Minimum License(s) and Certification(s):All certifications are required upon hire unless otherwise stated.
Lic Clinical Social Worker GA or Lic Master Social Worker GA or Reg Nurse (Single State) or RN - Multi-state Compact required.
Basic Life Support or BLS - Instructor required.
Required Minimum Experience:
Minimum 3 years management experience of a multidisciplinary staff in the field of case management or quality and patient safety is required.
Minimum 6 years of experience in a hospital environment is required.
Strong supervisory experience showing proven track record is required.
Clinical Practice/Experience is required in licensed field.
Experience in case management and/or social work is required.
Strong employee engagement skills demonstrated by results is required.
Required Minimum Skills:
Excellent organizational, verbal, and written communication skills
Independent and self-directed
Strong ability to manage data - interpret and analyze
Ability to handle and manage change, perform critical analysis, and mentor and develop direct reports
Knowledge of management practices and procedures, budgetary process and development and administrative and operational process
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Job Summary:
The Director of Care Coordination will work closely with the CMO, CFO and other members of the senior leadership team to build strategies that are aligned with current performance and hospital goals and vision for the care management program, timely patient throughput, appropriate care and utilization, safe disposition planning as well as utilizing data and analytics to drive departmental performance. The director will be responsible for adherence to the system Utilization Management Plan and care coordination policies and procedures, Care Coordination standards of care, CMS and other Payer regulations, Joint Commission regulations, and will ensure that the system strategic vision is fully integrated into the culture of the care coordination program. Will align closely with physician and share performance data with individual physicians and service lines.
The Director of Case Management is responsible for the day-to-day operations for all case management activities across the hospital, including utilization management, safe transitions planning, financial performance related to payer authorization processes, avoidable day tracking and reporting, medical necessity, ongoing quality, productivity and overall efficiency for case management processes. This director will ensure that the system standardize care coordination processes are implemented and followed always. As part of the role, the director will collaborate with physicians and other departmental leaders and staff to ensure that barriers to CM outcomes such as length of stay (LOS), avoidable days, readmissions, payer denials and other CM related outcomes are addressed timely with attention given to identifying root causes and driving performance improvement initiatives that ensures performance is aligned to targeted goals. Must be able to manage, interpret and share data.
Other duties of the director include creating and enhancing current tools, methodologies, recruiting practices, and personnel development processes. Plays a key role in the retention, professional development and performance review of staff, including mentoring, coaching, performance appraisals and recruiting as well as departmental budgets. The director participates in committees with the hospital medical staff and other leaders to address and solve issues that drive variation from goals. Is also responsible for collaborating with other key departments that drive throughput delays and work to jointly eliminate those barriers.
Required Minimum Education:
Bachelor's Nursing or Master's Social Work required.
Master's Public Health - Preferred
Master's Health Administration - Preferred
Required Minimum License(s) and Certification(s):All certifications are required upon hire unless otherwise stated.
Lic Clinical Social Worker GA or Lic Master Social Worker GA or Reg Nurse (Single State) or RN - Multi-state Compact required.
Basic Life Support or BLS - Instructor required.
Required Minimum Experience:
Minimum 3 years management experience of a multidisciplinary staff in the field of case management or quality and patient safety is required.
Minimum 6 years of experience in a hospital environment is required.
Strong supervisory experience showing proven track record is required.
Clinical Practice/Experience is required in licensed field.
Experience in case management and/or social work is required.
Strong employee engagement skills demonstrated by results is required.
Required Minimum Skills:
Excellent organizational, verbal, and written communication skills
Independent and self-directed
Strong ability to manage data - interpret and analyze
Ability to handle and manage change, perform critical analysis, and mentor and develop direct reports
Knowledge of management practices and procedures, budgetary process and development and administrative and operational process
#J-18808-Ljbffr