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

Orlando Health • Wesley Chapel, FL

77d

About The Position

The Director of Care Management at FMCOH Wiregrass Ranch Hospital in Wesley Chapel leads the care management team in facilitating appropriate use of hospital resources and effective discharge planning and coordination of services to transition patients to the next appropriate level of care. This role is crucial in managing educational, financial, and human resources 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.

Nice To Haves

• At least two (2) years in utilization management.

Responsibilities

• Manages educational, financial and human resources for the care management teams.
• Coordinates workload distribution and scheduling of care management team members.
• Develops collaborative relationships with site leadership, medical staff leadership, managed care contractors, and community leaders.
• Supports positive relationships with payors and develops plans to optimize reimbursement and quality of care.
• Monitors working DRGs and GMLOS assignment as appropriate.
• Implements the performance improvement process including outcome measurement.
• Develops strategies to manage patient care across the continuum.
• Supports clinical quality/cost-improvement initiatives and preventing re-hospitalizations.
• Develops recommendations to expand integration of post-acute care services.
• Designs educational strategies to assure compliance with regulatory standards.
• Coordinates budget implementation regarding payroll, supplies, and other functions.
• Serves as a department intermediary for service problems.
• Ensures incident reports are completed appropriately.
• Organizes and leads staff meetings and huddles.
• Embraces, promotes and communicates change.
• Demonstrates professional accountability and involvement in professional organizations.
• Holds self and others accountable to Orlando Health's mission, vision and values.
• Develops and recommends concepts for new business opportunities.
• Manages various human resources functions including hiring and performance counseling.
• Maintains regular, punctual attendance consistent with Orlando Health policies.
• Maintains compliance with all Orlando Health policies and procedures.
• Knowledge of hospital and department policies and procedures.
• Ability to compile, analyze and interpret data.
• Serves as facilitator to physicians and nursing staff on utilization and discharge planning.
• Demonstrates knowledge of labor and expense budgets, as well as revenue and census projections.
• Maintains confidentiality of data and information.

What This Job Offers

• Job Type: Full-time
• Industry: Religious, Grantmaking, Civic, Professional, and Similar Organizations
• Education Level: Master's degree
• Number of Employees: 5,001-10,000 employees