Aspirus-posted 3 months ago
Full-time • Senior
Wausau, WI
5,001-10,000 employees
Hospitals

Aspirus is seeking a Director - System Care Coordination to join our team at the Aspirus Wausau Corporate Office! The Director - System Care Coordination is responsible for system-wide Care Coordination functions (Utilization Review, Social Work, Navigation, and Case Management) including the execution of the care coordination strategic plan for the health system and the health plan, which includes organizing and directing an integrated cross-continuum care management and transitions of care program that monitors (on both an individual case and aggregate level) and directs actions to ensure achievement of health system and health plan goals, initiation of change management processes, and implementation of best practices, policies, and procedures. The position is responsible for all Aspirus entities (hospitals, clinics, post-acute care, and contracted care coordination services provided through Aspirus Business Health and the Aspirus Health Plan) and has accountability for the overall supervision of all Registered Nurses, Social Workers, and other healthcare providers in the area under their direction. The Director - System Care Coordination is responsible for recruitment and retention, performance reviews, professional development, and delivery of care management and transition services.

  • Oversee system-wide Care Coordination functions including Utilization Review, Social Work, Navigation, and Case Management.
  • Execute the care coordination strategic plan for the health system and health plan.
  • Organize and direct an integrated cross-continuum care management and transitions of care program.
  • Monitor individual cases and aggregate levels to ensure achievement of health system and health plan goals.
  • Initiate change management processes and implement best practices, policies, and procedures.
  • Supervise all Registered Nurses, Social Workers, and other healthcare providers.
  • Manage recruitment and retention, performance reviews, and professional development.
  • Bachelor's degree in Nursing.
  • Master's Degree in business, health care administration, or nursing.
  • Extensive knowledge of payer mechanisms and clinical utilization management.
  • Minimum of five years of experience in care management or utilization review.
  • Minimum of five to seven years of leadership experience in care coordination, case management, or utilization review.
  • Active Wisconsin or Michigan RN nursing license.
  • Nationally recognized certification (e.g., CPHQ, CCM, CPUM, CPUR, D-ABQAURP).
  • Knowledge of HEDIS, MIPS, Core Measures, NCQA.
  • Working knowledge of clinical systems and patient information systems.
  • Facility for data analysis and interpretation.
  • Full benefits packages available for part- and full-time status.
  • PTO accrual from day one.
  • Generous retirement plan with match available.
  • Wellness program for employees and their families.
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