Transition Care Director

AdventHealth•Daytona Beach, FL

37d•Onsite

About The Position

Responsible for overseeing the Care Management team and the avoidable readmission process to ensure appropriate length of stay and reduce readmissions within 30 days of discharge. This position manages the Transitional Care team to provide transition management for patients discharged to destinations other than home. Additionally, this role collaborates with acute care managers, home care liaisons, physicians, pharmacists, nursing leadership, and staff nursing. In addition, this position participates in routine readmission meetings with community partners and complies with data collection expectations. Ensures strategies are appropriate to the level of care required for discharged patients

Requirements

Graduate of accredited school of nursing
Current and active licensure as a Registered Nurse
2 of director level (or above) experience in care management
4 of care management experience performing hospital discharge planning

Nice To Haves

3 of director and/or manager of care management level of experience
5 care management leadership (manager level or above) in addition to 5 years of direct care management/utilization management experience and increasing leadership responsibility
RN-Board Certified (RN-BC)
Clinical Social Worker License (LCSW)

Responsibilities

Directs the daily operations of the Care Management department, including all aspects of care coordination, care transition, and compliance guidelines.
Implements strategies to improve operations and outcomes related to readmissions and care management.
Develops proactive strategies and methods necessary for a high-performance culture related to readmissions and care management.
Oversees the reduction of readmission rates concerning CMS targeted diagnoses. Supervises contracted and employed resources to meet readmission success indicators. Coordinates care with the hospital team and community to ensure patients have the necessary resources for successful discharges and reduced readmission risk.
Participates in interdisciplinary committees and collaborates with clinical informatics leaders, physician liaisons, nursing, patient care management department, and medical staff to achieve readmission and care management goals.