The System Director of Care Coordination is an integral part of the system leadership team with responsibility over the Social Services / Case Management departments throughout Community Medical Centers.
This position is accountable for directing, coordinating, and evaluating the delivery of service throughout the continuum of care, consistent with CMC Mission and Goals. Leverages data and trends to achieve strategic goals specific to the severity-adjusted length of stay, physician and patient satisfaction, with throughput and discharge planning. Leads and mentors staff including facility-specific leaders.
Your Career at Community | Opportunity. Challenge. Growth.
In this role some of your key responsibilities would include but are not limited to:
-Develops, implements and monitors strategic plan for CMC Care Coordination Team to meet the needs of the patient population as we transition from a fee for service model to a value based, outcomes based reimbursement model.
-Implements and maintains appropriate staffing models to ensure proactive discharge planning; creating work processes that are supportive of the care management team to ensure success, and create a collaborative work environment resulting in an engaged and accountable team.
-Develops/implement a plan to leverage other case management services and social service resources available to CMC through payer and contract relationships.
-Works collaboratively with physician leaders on identification of barriers and barrier resolution impacting throughput, physician and patient satisfaction with the discharge process and physician education.
-Builds and maintains solid relationships and service level agreements with post-acute providers, community resources, and regulatory agencies to ensure programs and processes are in place to meet the patients’ post-acute needs in a timely, safe, and cost-effective manner.
-Utilizes data to continually monitor key performance indicators (including length of stay) to identify and implement continuous quality improvement initiatives.
-Establishes and maintains effective documentation standards that facilitate transparent discharge planning and barrier resolution.
-Engages key ancillary (including utilization management), nursing resources, and physician leaders in the identification of barriers and barrier resolution, to manage all patient’s length of stay and cost, to ensure an efficient and effective, safe, care coordination and discharge process.
-Represents the service/program area with management, committees, and outside entities. Collaborates with other areas/programs or outside entities as necessary to support and enhance CMC mission and goals.
-Keep current with new laws and regulation requirements and anticipate changes and their implications.
-Establishes policies, procedures, and practices necessary for the effective and efficient human resource, business, and regulatory operations of the service/program area. Ensures these policies, procedures and practices are in accordance with appropriate laws and regulations.
-Develops, implements and maintains the annual operating budget ensuring that the operations are managed within the established guidelines.
-Direct various HR actions including, but not limited to, hiring, performance appraisal, disciplinary actions, transfers, promotions and scheduled time off.
** Reflects the job's main responsibilities and is not intended to be an exhaustive list of all duties performed; therefore, its content does not restrict management's right to assign or reassign duties and responsibilities to individuals in this job.
Experience and education minimum requirements:
-Bachelor’s degree in Healthcare or related field
-5-10 years of Case Management experience
-Previous Management experience
-Experience with decreasing insurance denials, developing / overseeing programs that address length of stay and cost reduction, performance improvement initiatives and an understanding of Medicare / Medicaid payment rules, polices and regulations.
-Experience in managed care organizations or third party payer industry
-Master’s degree in Business or Healthcare Administration or related field
Licenses & Certifications Required:
-California State Registered Nursing License
Job ID: 2019-13197