Director, Care Management - Wiregrass Ranch Hospital, Wesley Chapel, Florida

Florida Medical Clinic • Wesley Chapel, FL

79d

About The Position

The Director of Care Management leads the care management team at FMCOH Wiregrass Ranch Hospital in Wesley Chapel. This role is responsible for facilitating the appropriate use of hospital resources and ensuring effective discharge planning and coordination of services to transition patients to the next appropriate level of care. The director manages educational, financial, and human resources for the care management teams to deliver high-quality, cost-effective, and responsive patient-focused health care services.

Requirements

• Graduate of an approved school of nursing, Master’s in Social Work (MSW), Mental Health Counseling (MHC), or Marriage and Family Therapy (MFT).
• Florida RN license required and maintained current if graduated from an approved school of nursing.
• BLS/Healthcare Provider certification required.
• Three (3) years of experience in chronic disease management, care management, care coordination, utilization management, or acute clinical care.
• Preferred to include at least two (2) years in utilization management.

Responsibilities

• Manage educational, financial, and human resources for the care management teams.
• Coordinate workload distribution and scheduling of care management team members.
• Develop collaborative relationships with site leadership, medical staff leadership, managed care contractors, and community leaders.
• Support positive relationships with payors and develop plans to optimize reimbursement and quality of care.
• Monitor working DRGs and GMLOS assignment as appropriate.
• Implement performance improvement processes including outcome measurement.
• Develop strategies to manage patient care across the continuum, focusing on high-risk, high-cost, and problem-prone areas.
• Support clinical quality/cost-improvement initiatives and prevent re-hospitalizations.
• Develop recommendations to expand integration of post-acute care services and hospital operations.
• Design educational strategies to assure compliance with regulatory standards.
• Coordinate budget implementation regarding payroll, supplies, and other financial performance functions.
• Serve as a department intermediary for service problems.
• Ensure incident reports are completed appropriately and follow up as needed.
• Organize and lead staff meetings and huddles.
• Embrace, promote, and communicate change.
• Demonstrate professional accountability and maintain proficiency in assigned role.
• Develop and recommend concepts for new business opportunities and organizational structuring.
• Manage various human resources functions including hiring, work assignments, coaching plans, and performance counseling.
• Maintain regular, punctual attendance consistent with Orlando Health policies.
• Maintain compliance with all Orlando Health policies and procedures.
• Compile, analyze, and interpret data using advanced spreadsheet generation and database management.
• Serve as facilitator to physicians and nursing staff on utilization and discharge planning.
• Demonstrate knowledge of labor and expense budgets, as well as revenue and census projections.
• Maintain confidentiality of data and information.

What This Job Offers

• Job Type: Full-time
• Career Level: Senior
• Education Level: Master's degree
• Number of Employees: 501-1,000 employees