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Director, Care Coordination

  • Job
    Full-time
    Senior Level
  • People, HR & Administration
    Healthcare
  • Blythe

AI generated summary

  • You must have a Bachelor's in Nursing or a Master's in Social Work, 3+ years management experience, 6+ years in a hospital, relevant licenses, and strong communication and organizational skills.
  • You will oversee care coordination operations, ensure compliance, analyze data, collaborate with physicians, manage staff development, and address throughput barriers to improve performance outcomes.

Requirements

  • Required Minimum Education
  • Bachelors Nursing or Masters Social Work required.
  • Masters Public Health-Preferred
  • Masters Health Administration-Preferred
  • Required Minimum License(s) And Certification(s)
  • All certifications are required upon hire unless otherwise stated.
  • Lic Clinical Social Worker GA or Lic Master Social Worker GA or Reg Nurse (Single State) or RN - Multi-state Compact required.
  • Basic Life Support or BLS - Instructor required.
  • Required Minimum Experience
  • Minimum 3 years management experience of a multidisciplinary staff in the field of case management or quality and patient safety is required.
  • Minimum 6 years of experience in a hospital environment is required.
  • Strong supervisory experience showing proven track record is required.
  • Clinical Practice/Experience is required in licensed field.
  • Experience in case management and/or social work is required.
  • Strong employee engagement skills demonstrated by results is required.
  • Required Minimum Skills
  • Excellent organizational, verbal, and written communication skills
  • Independent and self-directed
  • Strong ability to manage data - interpret and analyze
  • Ability to handle and manage change, perform critical analysis, and mentor and develop direct reports
  • Knowledge of management practices and procedures, budgetary process and development and administrative and operational process

Responsibilities

  • The Director of Care Coordination will work closely with the CMO, 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.

FAQs

What will the Director of Care Coordination be responsible for?

The Director of Care Coordination will be responsible for building strategies aligned with hospital goals, overseeing compliance with care management programs, ensuring timely patient throughput, and utilizing data to drive departmental performance.

What qualifications are required for this position?

A Bachelor's in Nursing or a Master's in Social Work is required. A Master's in Public Health or a Master's in Health Administration is preferred.

What certifications do I need to hold for this role?

You are required to hold a Lic Clinical Social Worker GA, Lic Master Social Worker GA, or RN - Multi-state Compact, as well as a Basic Life Support (BLS) certification upon hire.

How many years of experience are needed for this position?

A minimum of 3 years of management experience in case management or quality and patient safety is required, along with at least 6 years of experience in a hospital environment.

What skills are essential for the Director of Care Coordination?

Essential skills include excellent organizational, verbal, and written communication skills, the ability to manage and analyze data, handle change, perform critical analysis, and mentor direct reports.

Will there be opportunities for staff development and mentoring?

Yes, the Director will play a key role in the retention, professional development, and performance review of staff, including mentoring and coaching.

Is experience in clinical practice necessary?

Yes, clinical practice experience in the licensed field is required for this position.

Will the Director collaborate with other departments?

Yes, the Director will collaborate with other key departments to identify and eliminate barriers that drive throughput delays.

What are the expectations for performance improvement initiatives?

The Director is expected to address barriers to care management outcomes, such as length of stay and readmissions, and drive performance improvement initiatives to align with targeted goals.

What role does the Director play in departmental budgets?

The Director will be responsible for departmental budgets and ensuring financial performance related to payer authorization processes.

To enhance the health and well-being of every person we serve.

Science & Healthcare
Industry
10,001+
Employees
1993
Founded Year

Mission & Purpose

At Wellstar Health System, our mission is to enhance the health and well-being of every person we serve. Nationally ranked and locally recognized for our high-quality care, inclusive culture and world-class doctors and caregivers, Wellstar is one of the largest, most integrated healthcare systems in Georgia.