Director, Case Coordination

Hartford Healthcare•Manchester, CT

17h•Hybrid

About The Position

In collaboration with the VP of Patient Care Services, organizes, directs, manages, and evaluates patient care services to attain the goals of the Organization. Determines appropriate resources to promote efficient, effective, and compassionate patient care. Provides clinical and administrative leadership and expertise over the case coordination department and clinical nurse navigators. Facilitates an atmosphere of participative management and the development of collegial relationships. Is visible, accessible and committed to communicating effectively with staff. Creates a work environment that facilitates and encourages involvement of the staff in critical thinking to enact professional care management practice. Represents the organization in a positive and professional manner. This position is required to travel to the facilities within the organization and to professional meetings within the state.

Requirements

Bachelor’s Degree from an accredited school of Nursing
Master’s degree or evidence of current enrollment in an accredited program
A minimum of five (5) years of clinical experience in acute care, home care and long-term care in nursing leadership.
Current License as a Registered Nurse with the State of Connecticut
Must possess and maintain a valid driver’s license and an acceptable driving record in accordance with organizational policy.
Must be able to communicate effectively in English, both verbally and in writing.
Knowledge of continuity of care including health care systems, reimbursement systems and regulations that pertain to areas of responsibility.
Possess basic computer skills.
Must have reliable transportation.

Responsibilities

With the Medical Management Committee, develops the plan for medical management consistent with the goals of the Organization.
Facilitates committee and sub-committee activities to identify organizational issues through comparative data or Case Coordination feedback and seeks improvement.
Provides leadership and supervision to the Case Coordination Department to ensure that competent staff provides effective services. Services include Case Coordination, Medical Social Work, Utilization Review and Clinical Nurse Navigators.
Collaborates with financial and clinical departments and with medical staff to achieve/manage targets for length of stay (LOS) and days of payment lost through denied days by payers.
Collaborates with community providers and leadership to establish and maintain a continuum of services for patients.
Maintains effective relationships with community providers to resolve barriers to the timely discharge of patients and to address concerns about the quality of care provided in nursing homes or patients’ homes.
Ensures that the Organization is compliant with regulatory requirements and standards of care recommended by accrediting organizations relating to Case Coordination.
Co-Chairs the utilization review committee for the Organization to meet conditions of participation in the Medicare program.
Ensures that the requirements of condition are present and that the Organization is ensuring the health and safety of Medicare beneficiaries receiving services at our facilities.
Using data from various sources, recommends or implements timely and effective actions in response to market shifts, strategic planning, and areas within this scope of responsibility that need improvement.
Presents information logically in oral and written format with poise and self-confidence, using a variety of presentation methods.
Demonstrates a commitment to professional accountability and growth.
Implements changes in policies, procedures, and practice, based on evaluation of system problems within the department, to improve efficiency or effectiveness.