Create and implement strategies which are outcomes focused and managed in a cost effective manner to reduce readmissions, manage length of stay and support overall patient throughput. Manage statistical and qualitative information concerning patient outcomes and physician/hospital practice patterns in accordance with health plan standards.
Optimize case management resources and processes for both outpatient and inpatient populations to ensure the seamless interaction, and shared goals among the patient’s care team. Evaluate all patient handoffs to ensure the selection of the best support resources delivered to the patient in a coordinated fashion at the right time in the right setting.
Direct the development of meaningful case management reports to assess the allocation of case management resources for specific populations. Collaborate with medical directors to establish, track, and report medical utilizations benchmarks; develop and test innovative programs/initiatives as needed for performance improvement; and provide expertise in the selection and use of outside vendors and other leveraged support resources. Provide leadership and expertise in securing regulatory and health plan compliance with case management standards of practice, contribute to organization-wide quality improvement initiatives, and lead the design, implementation and evaluation of nursing policy and protocol across the continuum of care.
Collaborate with leadership teams across the organization to facilitate the achievement of common business goals and share case management subject matter expertise and program successes. Establish and maintain programs for systematic, continuous evaluation of and utilization of department resources.
Provide overall administration, direction coordination of care transition services and development functions for the following areas: care transitions, case management, social work, and utilization management. Ensure these support services are integrated into the overall strategic goals of nursing and patient care services. Direct and coordinate a system to provide comprehensive and timel
y coordination of patient care by case management, social work and utilization management within and across Nebraska Medicine. Work with the Chief Nursing Officer and Chief Financial Officer to monitor financial performance and addresses variances.
Req #: 41626