What are the responsibilities and job description for the Administrative Director of Care Management position at KLS Workforce Solutions?
A major healthcare organization in Atlanta is seeking to hire a Director of Care Management who will be responsible and accountable to work with the Directors of Case Management on the implementation of the case management program at the local level. The components/roles of the inpatient case management program consist of the following: Care Facilitation, Utilization Management, Case Management and Discharge Planning.
The Director is responsible for overseeing/suggesting the development of systems and processes for care/utilization management at the local level. In addition, the Director is responsible for monitoring the progress of hospital department activities related to discharge planning and clinical quality improvement. The Director works with the local level Directors on matters that impact resource utilization and promotes the effective and appropriate use of hospital resources. The Director supports the collection, analysis and reporting of financial and quality data related to utilization management, quality improvement and performance improvement. The Director promotes interdisciplinary collaboration, fosters teamwork and champions service excellence.
- Works in collaboration with the local level Directors of Case management to plans and coordinate all aspects of the local level program.
- Facilitates growth and development of the case management program consistent with enterprise wide philosophy and in response to the dynamic nature of the health care environment through benchmarking for best practices, networking, quality management, and other activities as needed.
- Identifies and achieves optimal targeted clinical and financial outcomes via the case management process.
- Assures that revenue, expenses, contribution margin and FTE’s meet or exceed budget.
- Prepares and submits budget and related reports.
- Forecasts and accurately projects expenses.
- Takes corrective action to address negative variances.
- Identifies and proposes capital budget items appropriately.
- Participates in the annual and interim performance appraisal reviews of the Directors of Case Management.
- Acts as liaison to facilitate communication and collaboration between all care partners (physicians, hospital staff, community care managers, nurses, community resources, corporate, etc.)
- Leads a high performance team of “system thinkers” who incorporate leadership principles and vision in performing the functions of case management.
- Uses data to drive decisions, plan, and implement performance improvement strategies for case management.
- Oversees the education of physicians, managers, staff, patients and families related to the case management process at the system level.
- Participates in this evolutionary process by constantly identify future needs of current customers and/or identifying potential new customers.
- Responsible for the ongoing development of the Care Management program to extend beyond the acute inpatient environment.
- Ensures safe care to patients, staff and visitors; adheres to all existing policies, procedures, and standards within budgetary specifications including time management, supply management, productivity and quality of service.
- Promotes individual professional growth and development by meeting requirements for mandatory/continuing education and skills competency; supports department-based goals which contribute to the success of the organization; serves as preceptor, mentor and resource to less experienced staff.
- Demonstrates commitment to caring for every member of our community by creating compassionate and personalized experiences. Models existing standards by providing safe, caring, personalized and efficient experiences to patients and colleagues.
- Other duties as assigned.
Requirements
Minimum Qualifications
Education: Bachelors of Nursing (BSN) or Masters Social Work (MSW). Masters degree preferred
Licenses/Certifications:
Current and valid license to practice as a Registered Nurse in the state of Georgia or
Current and valid Georgia as a Master’s Social Worker (LMSW) required,
LCSW preferred and Certified Case Manager (CCM), Accredited Case Manager (ACM) or
Fellowship of the American Academy of Case Management (FAACM) required .
Experience/ Knowledge/ Skills:
Minimum five (5) years’ experience in utilization management, case management, discharge planning or other cost/quality management program
Three (3) years of experience in hospital-based nursing or social work preferred
Knowledge of leading practice in clinical care and payor requirements
Self-motivated, proven communication skills, assertive
Background in business planning, and targeted outcomes
Working knowledge of managed care, inpatient, outpatient, and the home health continuum, as well as utilization management and case management
Working knowledge of the concepts associated with Performance Improvement
Demonstrated effective working relationship with physicians
Ability to work collaboratively with health care professionals at all levels to achieve established goals and improve quality outcomes
Effective oral and written communication skills
Principal Accountabilities
Benefits
DENTAL INSURANCE
MEDICAL INSURANCE
VISION INSURANCE
LIFE INSURANCE
RETIREMENT
EQUITY
PAID TIME OFF