Director, Care Management - Wiregrass Ranch Hospital, Wesley Chapel

Orlando Health•Wesley Chapel, FL

19h•Onsite

About The Position

Elevating Healthcare in Wesley Chapel and West Florida, Florida Medical Clinic Orlando Health Wiregrass Ranch Hospital is poised to revolutionize healthcare in Wesley Chapel and the broader West Florida region. This five-story, state-of-the-art multi-specialty hospital spans 380,000 square feet, purpose-built to serve one of Florida’s fastest-growing communities with exceptional, outcomes-focused care. Designed for Excellence: Opening with 102 beds, expandable to 300 beds at full build-out 9 advanced operating rooms, including a hybrid OR with real-time imaging capabilities Comprehensive services in cardiology, neurology, oncology, surgery, and more From life-saving procedures to advanced diagnostics, this facility is engineered to meet the evolving needs of our community with precision and compassion. Job Summary 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.

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. and BLS/Healthcare Provider certification required.
BLS/Healthcare Provider Certification within 90 days of hire.
Three (3) years of experience in chronic disease management, care management, care coordination, utilization management, or acute clinical care.

Nice To Haves

Preferred to include at least two (2) years in utilization management.

Responsibilities

Manages educational, financial and human resources for the care management teams to deliver high quality, cost effective, and responsive patient-focused health care services.
Coordinates the workload distribution and scheduling of the care management team members to assure adequate and appropriate staffing to meet the needs of patients and families within the Orlando Health network.
Develops collaborative relationships with the site leadership, medicalstaff leadership, managed care contractors, and community leaders.
Supports positive relationships with payors and develops plansto optimize reimbursement and quality of care.
Monitors working DRGs and GMLOS assignment as appropriate.
Implementsthe performance improvement processto include outcome measurement asitrelatesto the identification of processes/ strategies/ opportunities that promote population health.
Achievesresults by developing strategiesto manage patient care acrossthe continuum, focusing on high risk, high cost and problem prone areas to include patient at risk for re-admission.
Supports processes for clinical quality/ cost-improvement initiatives/ preventing re-hospitalizations.
Develops recommendations to expand the integration of post-acute care services and hospital operations to better meet the needs of Orlando Health and the community.
Designs educational strategies to assure compliance with regulatory standards for NCQA, HIPAA, CMS, and other local, state and federal organizations as applicable.
Coordinates budget implementation with regard to payroll,supplies and miscellaneous otherfunctionsthat deal with the financial performance of the departments overseen,
Serves as a department intermediary forservice problems.
Ensuresincident reports are completed appropriately and follows up with incidentreports as needed.
Organizes/leadsstaff meetings and huddles.
Embraces, promotes and communicates change.
Demonstrates professional accountability by maintaining proficiency in assigned role and involvement in professional organizations and continuing education.
Holdsself and others accountable to Orlando Health’s mission, vision and values.
Develops and recommends concepts relative to new business opportunities, subsidiary organizations, acquisitions, current business design or other organization structuring to optimize organizationalstrength and meet operating mission.
Manages various human resources functions including hiring, work assignments, coaching plans, and performance counseling.
Maintains reasonably regular, punctual attendance consistent with Orlando Health policies, the ADA, FMLA and other federal, state and local standards.
Maintains compliance with all Orlando Health policies and procedures.