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    Director Care Management - Orlando, United States - AdventHealth

    AdventHealth
    AdventHealth Orlando, United States

    1 week ago

    AdventHealth background
    Description

    All the benefits and perks you need for you and your family:


    • Benefits from Day One
    • Paid Days Off from Day One
    • Debt-free Education* (Certifications and Degrees without out-of-pocket tuition expense)

    Our promise to you:

    Joining AdventHealth is about being part of something bigger.

    It's about belonging to a community that believes in the wholeness of each person, and serves to uplift others in body, mind and spirit.

    AdventHealth is a place where you can thrive professionally, and grow spiritually, by Extending the Healing Ministry of Christ. Where you will be valued for who you are and the unique experiences you bring to our purpose-minded team. All while understanding that
    together we are even better.


    Schedule:
    FT

    Shift :


    Days

    The community you'll be caring for:


    • Located on a lush tropical campus, our flagship hospital, 1,368bed AdventHealth Orlando
    • We offer great benefits with immediate Health Insurance coverage
    • Career growth and advancement potential
    • Serves as the major tertiary facility for much of the Southeast, the Caribbean and South America
    • AdventHealth Orlando houses one of the largest Emergency Departments and largest cardiac catheterization labs in the country
    • We are already one of the busiest hospitals in the nation, providing service excellence to more than 32,000 inpatients and 125,000 outpatients each year

    The role you'll contribute:

    The Care Management Facility Director has full accountability and oversight for the overall operations of the Care Management department, including but not limited to:

    Coordination of Care, Centers for Medicare & Medicaid Services (CMS) Conditions of Participation, Discharge Planning, Social Services, Readmission Prevention, Length of Stay, Excess days, Avoidable Days, Value Based Care partnerships, Care Manager's roles in Multidisciplinary Rounds, Care Transitions, team member engagement, team member evaluations and customer experience.


    The Care Management Facility Director leads, manages, and supervises all activities of the Care Management Manager, Team Leads, Care Managers, Social Workers and Care Manager Assistants to ensure appropriate care coordination and care transition handoffs for all patients.

    The Care Management Facility Director will provide monthly metric reports and mitigation plans to the Care Management Divisional Director.

    The Care Management Facility Director reports directly to the Division Care Management Director with a matrix reporting relationship dotted line to the Facility CNO.

    The Care Management Facility Director works closely with the Facility CNO to implement the Corporate Care Management strategies.

    The Care Management Facility Director meets regularly with the CMO to align Care Management work with Providers and keep the CMOs updated.

    The Facility Care Management Director communicates regularly with the CFO to provide a bidirectional communication to keep Facility CFOs updated on Care Management initiatives and progress.


    The value you'll bring to the team:

    Directs the daily operations of the Care Management department, including all aspects of care coordination, care transition and compliance guidelines

    Implements the Corporate Care Management strategies

    Responsible for providing and or implementing strategies to improve operations and outcomes

    Determines proactive strategies and methods necessary for a high-performance culture related to Care Management

    Supports change management and movement toward interaction with outpatient Care Management

    Assists in the development and oversees the implementation of Care Management policies, procedures, and standards

    Participates in the development of new staffing and care designs that support system goals while achieving best in class performance

    Supports standards that are consistent with hospital, community and nationally recognized evidence-based practice

    Collaborates with C-Suite and other hospital leaders to maintain a collaborative professional relationship to achieve goals

    Works collaboratively with leaders of Utilization Management to quickly and efficiently address any Care Management or Utilization Management concerns or barriers

    Escalates operational and/or financial concerns to Physician Advisor(s) as appropriate

    Determines proactive strategies and methods necessary for a high-performance culture related to Care Management

    Identifies process improvement opportunities and develops, implements and monitors action plans based upon identified Care Management metrics

    Educates and mentors facility Care Management staff on interpretation of data and the performance of causal analysis Reports findings to appropriate facility and divisional leaders

    Achieves positive results for the organization related to investigations of complaints requiring the Director's direct involvement

    Available for oneon-one meetings with a wide range of stakeholders for education/development and problem - solving

    Maintains excellent professional relationships with facility and divisional leadership

    Communicates and collaborates across the facility in the areas of data and information management, performance improvement, care coordination, care transition management, medication management, and social services

    Provides leadership to and actively participates with facility staff to identify, implement, or enhance Care Management programs consistent with AdventHealth and facility strategy

    Ensures the facility's Care Management staff are practicing at the highest level of excellence

    Oversees the effectiveness of the department's recruitment and retention program, taking action as necessary to provide an adequate level of qualified staff

    Coaches/mentors staff to improve their performance and develop their professional skills

    Identifies leadership talent and actively develops leadership skills in staff

    Supports diversity objectives of the organization in recruiting and promoting

    Creates and implements change management strategies and plans that maximize employee adoption and minimize resistance

    Compiles and reviews budgets and justifications submitted by Care Management Manager

    Provides assistance to the Care Management Manager and Supervisor to develop action plans that address variances

    Utilizes management reports to evaluate budget and staffing variations

    Assists Care Management Divisional Director with operating budget for Care Management


    KNOWLEDGE AND EXPERIENCE STRONGLY PREFERRED:

    Understanding of medical necessity for appropriate patient status and level of care

    Understanding of Care Management best practices

    Ability to research and reason best practices to support process improvement

    Strong verbal and electronic communication skills

    Ability to analyze, evaluate and monitor data in addition to provide action plans

    Supports positive employee relations and customer experience

    Understanding of Microsoft Office Products and other appropriate software platforms

    Understanding of CMS Conditions of Participation for Discharge Planning

    Understanding of Managed Care and Value Based Programs

    Ability to work autonomously with self-direction

    Ability to work as a collaborative partner of a diverse leadership team

    Ability to lead and sustain change

    Knowledge of change management principles, methodologies, and tools


    KNOWLEDGE AND EXPERIENCE PREFERRED:

    3-5 years of Director and/or Manager of Care Management level of experience

    Sustained goals of Care Management metrics, voice of the customer experience, employee engagement, and quality outcome viability of a Care Management program

    Qualifications


    The expertise and experiences you'll need to succeed:


    EDUCATION AND EXPERIENCE REQUIRED:

    Registered Nurse:


    BSN
    Social Worker:

    MSW or BSW Masters in related field

    5 years of Care Management experience performing hospital discharge planning

    3 years of Manager level (or above) experience in Care Management/Social Work leadership


    EDUCATION AND EXPERIENCE PREFERRED:

    Registered Nurse:


    MSN
    Social Worker:

    MSW with LCSW

    5-7 years in Care Management leadership (manager level or above) in addition to 5 years of direct Care Management/Utilization Management experience and increasing leadership responsibility

    LICENSURE,


    CERTIFICATION OR REGISTRATION REQUIRED:

    :

    State Specific RN license if a nurse

    LICENSURE, CERTIFICATION OR REGISTRATION PREFERRED:

    RN-BC Certification in Care Management

    This facility is an equal opportunity employer and complies with federal, state and local anti-discrimination laws, regulations and ordinances. The salary range reflects the anticipated base pay range for this position. Individual compensation is determined based on skills, experience and other relevant factors within this pay range. The minimums and maximums for each position may vary based on geographical location.


    Category:
     Case Management


    Organization:
     AdventHealth Orlando


    Schedule:
     Full-time


    Shift:
     - Day


    Req ID:


    We are an equal opportunity employer and do not tolerate discrimination based on race, color, creed, religion, national origin, sex, marital status, age or disability/handicap with respect to recruitment, selection, placement, promotion, wages, benefits and other terms and conditions of employment.

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