Director Care Management - Northern Region, St. Vincent

Highmark Health•Erie, PA

14h

About The Position

St. Vincent Hospital is a Magnet®-designated hospital for excellence in nursing, serving the people in the Lake Erie region since 1875 with a quality of care and service second to none! Allegheny Health Network At AHN, employees trust working together and place patients at the center of all they do. This 9 Hospital system, a part of Highmark Health, is transforming the future of healthcare by providing highly effective services to customers, patients and communities. AHN has commitment and dedication to being inclusive, valuing fresh perspectives, and offering the best growth and educational opportunities to employees. GENERAL OVERVIEW: Provides operational and strategic leadership for Hospital/facility Care Management Department. Collaborates with nursing and clinical leaders to assure smooth patient care progression and effective outcomes and care transitions. Directs collaborative efforts with physicians, revenue cycle and payor teams, and patients and their families to incorporate evidence based practices and appropriate use of resources. Communicates effectively with Hospital leadership in the development of day to day and strategic goals.

Requirements

Minimum Master’s Degree in Nursing, social work, or related healthcare field
5 years in Complex Transition Management
5 years in a formal management role
Demonstrated critical and strategic thinking skills and experience
Current State of PA RN licensure OR Current multi-state licensure through the enhanced Nurse Licensure Compact (eNLC) OR Licensed Social Worker
Strong communication and collaboration skills
Problem-solving
Resilient and agile change agent
Microsoft office suite
Act 34 Criminal Background Clearance Certificate.
Act 33 Child Abuse Clearance Certificate.
Act 73 FBI Fingerprinting Criminal Background Clearance Certificate.

Nice To Haves

Professional Case Management certification within 3 years of hire

Responsibilities

Evaluates effectiveness, leads improvement efforts, and assesses outcomes within Hospital to assure appropriate access, care progression, transition, and level of care determination practices. (20%)
Studies and implements the care management model and structure to achieve sustainable length of stay, resource utilization, and clinical outcomes for patients over time. Responsible for designing and implementing improvement strategies for the care model on an ongoing basis. (20%)
Directs and oversees all activity related to referral management. Leverages Epic and Careport/Allscripts data to assess effectiveness. Collaborates closely with Highmark Home and Community Services to establish and/or enhance post-acute network. (15%)
Analyzes clinical service areas for operational effectiveness, using dashboards and other data sources. Monitors departmental performance against system initiatives and goals. ( 10%)
Assures that department works collaboratively with patients, families, peers, and other departments in the organization/network to meet established organizational goals for patient experience. (10%)
Pursues sharing of best practices through publication, presentation at conferences and networking with other AHN leaders throughout the system. (10%)
Establishes a development plan for the department, with a focus on effective use of resources, inter-professional collaboration, and coordination with chronic disease, transitional planning, and specialty teams. (5%)
Develops and implements workflows which assure efficient care coordination and transition, Hospital throughput, and adherence to payer requirements in order to minimize financial risk to patients and the health system. (5%)
Lead and support evidence based projects & research by assisting in the identification of opportunities to incorporate the scientific method into practice. (5%)
Other duties as assigned.