Director, Care Management

Orlando Health•Orlando, FL

5h•Onsite

About The Position

Orlando Health Arnold Palmer Hospital for Children, located on the downtown Orlando Health campus, has been providing compassionate care to children, teenagers, and young adults for over 30 years. With 156 licensed beds and expertise in over 30 pediatric specialties, the hospital has received numerous accolades, including "Best Children’s Hospitals" recognition by U.S. News & World Report for 14 consecutive years and a Top Children’s Hospital designation by the Leapfrog Group. Orlando Health Arnold Palmer has maintained Magnet® Recognition for nursing excellence since 2013, and several units have earned Beacon Awards for Excellence. The hospital features Central Florida's only pediatric Level I Trauma Center and ER dedicated exclusively to children, and is the only facility in Florida with Level I Children’s Surgical Verification and Level I Trauma Verification by the American College of Surgeons. As part of the Orlando Health system, which spans Florida's coasts, the organization comprises over 27,000 team members dedicated to providing professional and compassionate care. Orlando Health is committed to offering comprehensive benefits, including career-growing education programs and well-being services, starting from day one, with a focus on flexibility and supporting employees' passions. The Arnold Palmer Hospital for Care Management Department is seeking a Director to lead the care management team in optimizing hospital resource utilization, facilitating effective discharge planning, and coordinating services for patient transitions 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.
Three (3) years of experience in chronic disease management, care management, care coordination, utilization management, or acute clinical care.
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, 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 to include outcome measurement as it relates to the identification of processes/strategies/opportunities that promote population health.
Achieves results by developing strategies to manage patient care across the continuum, focusing on high risk, high cost and problem prone areas to include patients 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 other functions that deal with the financial performance of the departments overseen.
Serves as a department intermediary for service problems.
Ensures incident reports are completed appropriately and follows up with incident reports as needed.
Organizes/leads staff 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.
Holds self 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 organizational strength 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.