Director, Care Management (Multispecialty & Research Hospital)

Job Summary:

The Director of Care Management is responsible for leading a dynamic team of clinical professionals in the execution of exemplary cross continuum care coordination. This individual works with market leaders, physicians, peers, community colleagues, system leaders and others to identify opportunities to continually improve patient care and services, and to execute collaborative practices that exemplify the MSRH commitment to patient centered care and community engagement.

Job Duties:

• Serve as “Program Champion” for Care Management as part of an overall plan for census growth and stability for all assigned programs/populations.
• Use monitoring and measurement tools to ensure effectiveness in all service areas according to defined parameters.
• Ensure that patient satisfaction targets, regulatory compliance requirements, documentation standards, and certification requirements are met.
• Assure that appropriate safety and clinical standards of care are met for care management in accordance with all applicable regulatory accreditation (CMS, applicable state licensing departments, CARF, The Joint Commission, etc.) requirements, hospital policies and procedures and industry standards for clinical practice.
• Collaborate with the other unit Directors, Medical Directors, hospital staff and physicians to serve as point of contact for clinical information, problem-solving and networking for all assigned programs/populations.
• Responsible for assuring appropriate staffing levels, equipment, and supplies to meet patient care manager needs.
• Maintains accountability for meeting established financial performance metrics for assigned departments.
• Submits operational and capital budgets for case management, monthly financial performance indicators, approves expenditures for supplies and service as necessary.
• Oversees and directs the work of the Clinical Case Managers, Utilization Case Managers, and Social Workers.
• Creates accountability and escalation pathways for resolving Care Coordination.
• Perform other duties as assigned.

Education:

MSN or Master of Social Work required

Experience :

Seven (7) years clinical experience and/or case management, utilization review, or hospital quality assurance experience

Four (4) years of supervisory experience in related field. Healthcare leadership experience preferred

Licenses/Certifications:

Current Texas Registered Nurse License or Licensed Master Social Worker (LMSW) upon hire

Certification in Case Management (CCM or ACM) within 1 year of hire

Additional Information