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Location

Roswell, GA | United States

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Job description

Overview

The Director of Care Coordination will work closely with the VPMA, 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 address 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.

Qualifications

Required Minimum Education

• Bachelor's Degree BSN graduate from an accredited school of Nursing with a current RN license in the State of Georgia is required.
• Master's Degree in Public Health (MPH), Business Administration (MBA),or Healthcare Administration is preferred. 

Required Minimum Experience

• Minimum 3 years to 5 years management experience of a multidisciplinary staff in the field of case management or quality and patient safety with at least 6-8 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 is required. 
• Experience in case management and/or social work is required.
• Strong employee engagement skills demonstrated by results 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

Required Minimum License(s)

• Lic Clinical Social Worker GA or Lic Master Social Worker or GA RN or RN Multi-state Compact required.

Required Minimum Certification(s)

• Basic Life Support 

We’d like to invite you on a career journey like no other! In return for your contributions, we’ll help you make the most of all life’s moments – on and off the job. Wellstar Total Rewards is designed to provide for your total well-being, including: Your Wellness, Your Pay, Your Future, Your Joy. We think it’s pretty simple – we care for our team members and our team members care for the community.

Make a difference in patients’ lives… and your own! Here, it’s more than healthcare – it’s CareerCare!

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Job tags

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Salary