Director Inpatient Care Management

Advocate Health and Hospitals Corporation • Wake Forest, NC

3d • $63 - $95

About The Position

Strategy & Integration – Accountable for contributing to development of the enterprise strategic and annual operating plans for care coordination inpatient and ED care management programs in alignment with enterprise population health. Integrates national best practices and benchmarks into the program to ensure optimal outcomes for the healthcare system. Ensures the care management inpatient program goals are aligned with the overall strategic initiatives in enterprise population health. Responsible for developing a professional, team-oriented, service culture that contributes to the goals of the enterprise and department. Has expert knowledge of the processes related to financials in the revenue cycle model; supports and directs initiatives that result in improved quality, efficiency and financial performance. Performance Management - Provides accountability and oversight for the development of structures, processes and initiatives designed to improve care coordination projects that will define the continuum of care for each patient population and best practice solutions for care coordination. Ensures a plan for education, communication, training and implementation planning. Serves as a leader for oversight for the CM leaders to ensure delivery of the vision, strategies, and roadmap including utilization outcomes, process metrics, and financial performance of all value based contracts (significant impact on financial performance). Provides leadership/mentorship to site leaders of CM for effective implementation and optimal performance. Leads in setting performance management goals, operating plans, dashboards, and outcome tracking tools to ensure performance is monitored, on target and achieving intended outcomes. Rounds on site CM leaders including observations and onsite reviews/rounds to ensure project deployment and operation are in alignment with system goals/targets. Works with performance improvement and project managers as project leads related to care coordination tactics as assigned (Medicare Bundled Payments for Care Initiatives and Medicare Shared Savings Program). Communication / Relationships – Accountable for communication and data reporting to Site Leadership Teams and key stakeholders. Provides leadership and mentorship to site managers and supervisors to ensure effective implementation, change management, and optimal performance. Collaborates with AVP in setting KPIs, operating plans, dashboards, and outcome tracking tools to ensure performance is monitored, on target and achieving intended outcomes. Budgeting – Accountable for site operating / capital budgets Regulatory & Compliance – Ensures that the site care management programs for the assigned region operate under compliant CMS, federal and state practice standards and codes of ethics. Technology – Ensures appropriate care management tools and software are operational and support the needs of the strategic plan and initiatives for Integrated Care Management. Performs human resources responsibilities for staff which include interviewing and selection of new employees, promotions, staff development, performance evaluations, compensation changes, resolution of employee concerns, corrective actions, terminations, and overall employee morale. Develops and recommends operating and capital budgets and controls expenditures within approved budget objectives. Responsible for understanding and adhering to the organization's Code of Ethical Conduct and for ensuring that personal actions, and the actions of employees supervised, comply with the policies, regulations and laws applicable to the organization's business.

Requirements

• Registered Nurse license issued by the state in which the team member practices.
• Accredited Case Manager (ACM) certification issued by the American Case Management Association (ACMA) needs to be obtained within 1 year, or Care Manager Certified (CMC) certification issued by the National Academy of Certified Care Managers (NACCM) needs to be obtained within 1 year, or Nursing Case Management (RN-BC) certification issued by the American Nurses Credentialing Center (ANCC) needs to be obtained within 1 year.
• Master's Degree in Nursing, or Bachelor's Degree in Nursing, and Master's Degree in Health Care Administration or related field.
• Typically requires 5 years of experience in clinical experience.
• Typically requires 3 years of management experience in clinical environment.
• Strong analytical ability to gather, interpret, and utilize data in decision-making
• Demonstrated self-direction and results orientation
• Expertise in operations improvement and quality management
• Demonstrated excellence in organizational and project management skill
• Critical thinking skills
• Proficiency with word processing, spreadsheet, PowerPoint and graphic presentation software
• Demonstrated political sensitivity to the dynamic interplay that occurs between hospital sites
• Demonstrated success facilitating teams on complex projects
• Strong leadership skills
• Ability to work in an unstructured, developing environment
• Flexible hours
• Frequent travel
• Experience in an integrated health care delivery model across a continuum of services such as care management models
• Understanding of analytics and performance metrics that drive behavior
• Experience working with contracts where financial performance is at risk for a health care delivery system
• Strong operational skills including strategic planning, operational work plans with demonstrated adherence to timelines
• Ability to lead a team and work with a diverse team of stakeholders
• Excellent presentation skills with experience communicating with high level executives internally and externally with outside stakeholders.

Responsibilities

• Strategy & Integration – Accountable for contributing to development of the enterprise strategic and annual operating plans for care coordination inpatient and ED care management programs in alignment with enterprise population health.
• Integrates national best practices and benchmarks into the program to ensure optimal outcomes for the healthcare system.
• Ensures the care management inpatient program goals are aligned with the overall strategic initiatives in enterprise population health.
• Responsible for developing a professional, team-oriented, service culture that contributes to the goals of the enterprise and department.
• Has expert knowledge of the processes related to financials in the revenue cycle model; supports and directs initiatives that result in improved quality, efficiency and financial performance.
• Performance Management - Provides accountability and oversight for the development of structures, processes and initiatives designed to improve care coordination projects that will define the continuum of care for each patient population and best practice solutions for care coordination.
• Ensures a plan for education, communication, training and implementation planning.
• Serves as a leader for oversight for the CM leaders to ensure delivery of the vision, strategies, and roadmap including utilization outcomes, process metrics, and financial performance of all value based contracts (significant impact on financial performance).
• Provides leadership/mentorship to site leaders of CM for effective implementation and optimal performance.
• Leads in setting performance management goals, operating plans, dashboards, and outcome tracking tools to ensure performance is monitored, on target and achieving intended outcomes.
• Rounds on site CM leaders including observations and onsite reviews/rounds to ensure project deployment and operation are in alignment with system goals/targets.
• Works with performance improvement and project managers as project leads related to care coordination tactics as assigned (Medicare Bundled Payments for Care Initiatives and Medicare Shared Savings Program).
• Communication / Relationships – Accountable for communication and data reporting to Site Leadership Teams and key stakeholders.
• Provides leadership and mentorship to site managers and supervisors to ensure effective implementation, change management, and optimal performance.
• Collaborates with AVP in setting KPIs, operating plans, dashboards, and outcome tracking tools to ensure performance is monitored, on target and achieving intended outcomes.
• Budgeting – Accountable for site operating / capital budgets
• Regulatory & Compliance – Ensures that the site care management programs for the assigned region operate under compliant CMS, federal and state practice standards and codes of ethics.
• Technology – Ensures appropriate care management tools and software are operational and support the needs of the strategic plan and initiatives for Integrated Care Management.
• Performs human resources responsibilities for staff which include interviewing and selection of new employees, promotions, staff development, performance evaluations, compensation changes, resolution of employee concerns, corrective actions, terminations, and overall employee morale.
• Develops and recommends operating and capital budgets and controls expenditures within approved budget objectives.
• Responsible for understanding and adhering to the organization's Code of Ethical Conduct and for ensuring that personal actions, and the actions of employees supervised, comply with the policies, regulations and laws applicable to the organization's business.

Benefits

• Advocate Health offers a comprehensive suite of Total Rewards: benefits and well-being programs, competitive compensation, generous retirement offerings, programs that invest in your career development and so much more – so you can live fully at and away from work, including:
• Compensation Base compensation listed within the listed pay range based on factors such as qualifications, skills, relevant experience, and/or training Premium pay such as shift, on call, and more based on a teammate's job Incentive pay for select positions Opportunity for annual increases based on performance
• Benefits and more Paid Time Off programs Health and welfare benefits such as medical, dental, vision, life, and Short- and Long-Term Disability Flexible Spending Accounts for eligible health care and dependent care expenses Family benefits such as adoption assistance and paid parental leave Defined contribution retirement plans with employer match and other financial wellness programs Educational Assistance Program

What This Job Offers

• Job Type: Full-time
• Career Level: Director
• Number of Employees: 5,001-10,000 employees