Director, Clinical Effectiveness & Care Management

The Director of Clinical Effectiveness and Care Management leads and manages a hospital-based team of professional staff, composed primarily of nurses and social workers. This team assesses plans, implements, coordinates, monitors and evaluates care, treatment and services to meet the patient's individual needs along with the healthcare continuum through providing utilization review services, care coordination, discharge planning and psycho-social services. Working collaboratively with physicians and other members of the multidisciplinary team, including next site of care representatives; this team ensures that patients receive the most effective and efficient care possible across the continuum of care. As a key leader in Norton Healthcare's Improvement Network, the Director of Clinical Effectiveness and Care Management will coach and facilitate this team in performance improvement initiatives to ensure patients receive high quality cost-effective care, evident in key performance measures such as Length of Stay and Readmission. In addition, this position will have the support of and work closely - collaboratively with other key leaders in the Improvement Network including Quality and Service Excellence. Tracking, trending, and reporting key financials, clinical and patient satisfaction outcomes to senior leadership will also be required.

Key Accountabilities:

• Demonstrates thought leadership in and execution of innovative programs to improve the quality of care, appropriate access and utilization of healthcare and containment of medical costs and moderate medical trends. Is responsible for achieving system care management Integration and Alignment Objectives. Plans and develops relevant programming to support current and new programs.
• Serves as a role model and mentor in the use of data to drive decisions and improvement strategies across the organization. Holds themselves accountable to the same performance expectations of those reporting to this role. Coaching and development to direct reports and other members of Norton’s Improvement Network. Consistently demonstrates and employs Norton Healthcare’s standards of service and values.
• Provides leadership in process improvement initiatives at the facility through planned, systematic, and ongoing processes for monitoring, evaluating and improving the quality of care provided and ensures care delivered adds value to the patient experience (best possible care/ outcomes at the lowest possible cost). Collaborates with nursing and other hospital departments (including but not limited to physicians, Clinical Effectiveness, Quality Directors…..) to maintain and improve quality of care and patient satisfaction. Utilizes quality assessment results to improve processes that affect patients care outcomes. Identifies work related problems with possible solutions and implements appropriate solutions. Mentors and coaches to key change leaders in the facility.
• Responsible for achieving annual care management performance metrics developed collaboratively with hospital and, as appropriate, system leadership; identifies and coordinates performance improvement opportunities and leads formal groups in rapid-cycle and performance improvement activities to move key performance measures such Length of Stay and Readmission rates. Value-based purchasing metrics related to patient satisfaction, core measures, efficiency, and patient outcomes will be closely monitored for improvement opportunities. Management of financial resources to meet and exceed the expected budget expectations. Overall administration and clinical direction and management of departments by facilitating the development and delivery of quality service by evaluating and coordinating the services provided. Improves asset utilization and cost structure through efficient utilization review and care management.
• Provides annual performance evaluations for direct reports and provides feedback to other system leaders re: performance of members within the Improvement Network. Provides staff management for direct reports. Evaluates annual employee engagement results and works with teams to establish action plans to ensure workforce concerns and needs are being addressed. Ensures resources, including workforce, have been accurately deployed to ensure optimal outcomes. Will mentor, coach, and support team members as needed to ensure members have right tools and training to deliver on expected outcomes/ goals.

Required:

• Three years in care management
• Master Degree
• Registered Nurse

Desired:

• Accredited Case Manager OR Certified Case Manager OR Nurse Executive Board Certified OR Nurse Executive Advanced Board Certified OR Certified Pediatric Nurse OR Case Management Administrator Certification OR Nursing Case Management Certification OR Case Manager Certified