Director, Care Coordination

Overview

How would you like to work in a place where your contributions and ideas are valued? A place where you can serve with compassion, pursue excellence and honor every voice? At Wellstar, our mission is simple, yet powerful: to enhance the health and well-being of every person we serve. We are proud to have become a shining example of what's possible when the brightest professionals dedicate themselves to making a difference in the healthcare industry, and in people's lives.

Responsibilities

WellStar Spalding Regional Hospital

Director of Care Coordination

The Director of care coordination will work closely with the VPMA, CFO and other members of the senior leadership team to build strategies that are aligned with current performance and hospital goals and vision for the care management program, timely patient throughput, appropriate care and utilization, safe disposition planning as well as utilizing data and analytics to drive departmental performance. The director will be responsible for adherence to the system Utilization Management Plan and care coordination policies and procedures, Care Coordination standards of care, CMS and other Payer regulations, Joint Commission regulations, and will ensure that the system strategic vision is fully integrated into the culture of the care coordination program. Will align closely with physician and share performance data with individual physicians and service lines.

The Director of Case Management is responsible for the day-to-day operations for all case management activities across the hospital, including utilization management, safe transitions planning, financial performance related to payer authorization processes, avoidable day tracking and reporting, medical necessity, ongoing quality, productivity and overall efficiency for case management processes. This director will ensure that the system standardize care coordination processes are implemented and followed always. As part of the role, the director will collaborate with physicians and other departmental leaders and staff to ensure that barriers to CM outcomes such as length of stay (LOS), avoidable days, readmissions, payer denials and other CM related outcomes are address timely with attention given to identifying root causes and driving performance improvement initiatives that ensures performance is aligned to targeted goals. Must be able to manage, interpret and share data

Other duties of the director include creating and enhancing current tools, methodologies, recruiting practices, and personnel development processes. Plays a key role in the retention, professional development and performance review of staff, including mentoring, coaching, performance appraisals and recruiting as well as departmental budgets. The director participates in committees with the hospital medical staff and other leaders to address and solve issues that drive variation from goals. Is also responsible for collaborating with other key departments that drive throughput delays and work to jointly eliminate those barriers.

Qualifications

Required Minimum Education: BSN graduate from an accredited school of Nursing with a current RN license in the State of Georgia and a Master’s Degree in Public Health (MPH), Masters in Business Administration (MBA), Masters in HealthCare Administration required.

Required Minimum Licensure/Certification: Valid RN License in the State of Georgia, BLS or a Master’s in Social Work (LMSW or LCSW) from an Accredited School, required. Licensure in SW is required.

Required Minimum Experience: Requires 3 to 5 years management experience of a multidisciplinary staff in the field of case management or quality and patient safety with at least 6-8 years of experience in a hospital environment is required. Strong supervisory experience showing proven track record; Clinical Practice/Experience is required in licensed field; Experience in case management and/or social work. Strong employee engagement skills demonstrated by results.