Houston Methodist-posted 2 months ago
Full-time • Senior
Houston, TX
5,001-10,000 employees
Hospitals

At Houston Methodist, the Sr Director Case Management position is responsible for providing executive leadership and strategic oversight for all hospital-based Case Management Directors and the Central Utilization Review Director across the system. This position is responsible for the integration and advancement of a unified case management model grounded in clinical excellence, throughput efficiency, care transitions, and denials prevention. A champion of a progressive care management model, the Sr Director Case Management position promotes innovative strategies while fostering interprofessional collaboration across clinical and administrative domains. This position leads enterprise-wide initiatives aimed at optimizing patient progression of care, aligning utilization review practices, enhancing discharge planning processes, and strengthening compliance with CMS Conditions of Participation. The Sr Director Case Management position will interface with system leadership, medical staff, physician advisors, population health, revenue cycle, and post-acute networks to ensure high-performance outcomes, efficient use of resources, and superior patient experiences.

  • Sets the strategic vision and administration and is responsible for multiple budgets (operational and capital) and/or directs work that has significant financial implications including high-level oversight of the activities within the assigned functional area(s), ensuring quality, productivity, functional excellence, and efficiency to accomplish strategic and operational objectives.
  • Directs, develops, and implements strategic and operational/high-level projects and processes through independent/highly autonomous work or through the facilitation of work teams to enable the effective and efficient completion of objectives.
  • Oversees and ensures development for staff to meet overall objectives in terms of quality, service, and cost-effectiveness.
  • Provides leadership and communication to maintain a competent and engaged employee group by conducting function leadership meetings to review policies and procedures and operational matters.
  • Identifies opportunities and takes action to build strategic relationships between one's functional area and other areas, teams, departments, and units to achieve business goals.
  • Collaborates with HMCPA on care transition and utilization management initiatives.
  • Provides strategic vision and execution for case management and utilization review across all hospitals and central departments.
  • Oversees functional area department operations, designated projects, schedules, and activities as needed to ensure that system goals or objectives are accomplished within the prescribed time frame.
  • Drives department service standards and activities to impact department and/or system score for patient/customer-based satisfaction.
  • Ensures a safe and effective working environment; monitors and/or revises the department safety plan and/or any specific accreditation/regulatory required safety guidelines.
  • Provides input on the development and management of operational and capital budgets, approvals, and ongoing maintenance of the department(s).
  • Identifies, designs, and ensures implementation of innovative solutions for the functional area.
  • Master's degree or higher from an accredited school of Nursing.
  • Seven years of experience in case management, utilization review, or care coordination, including five years progressive leadership people management experience.
  • RN - Registered Nurse - Texas State Licensure -- Compact Licensure - Must obtain permanent Texas license within 60 days (if establishing Texas residency).
  • Magnet ANCC-recognized Case Management certification.
  • Magnet ANCC-recognized Leadership certification within 1 year.
  • Demonstrated success leading multi-site or enterprise-level programs preferred.
  • Participation in ACMA, CMSA, or other national case management organizations encouraged.
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