The Director of Coordinated Care oversees a staff of case managers and social workers responsible for patient care coordination. Develops and implements case management programs, including utilization review, admission or discharge planning to facilitate appropriate utilization of resources and progression of patient through the healthcare continuum. Seeks solutions that balance clinical and financial concerns with the patient and family's needs and the patient's quality of life. Oversees the clinical documentation improvement program. Analyzes and evaluates ongoing departmental programs to identify areas where adjustments/improvements are needed. Initiates changes in or development of new policies, procedures, and/or methods to meet all regulatory compliance for third party payors. Serves as an organizational and community resource for patient progression needs. Is responsible for departmental budgeting and staffing.
1. Bachelor's Degree in health or business-related field, Master's preferred
1. Current Registered Nurse License with Georgia Board of Nursing
1. Extensive, relevant experience in a health-related discipline for a minimum of five (5) years
2. Ability to collect and interpret information related to the delivery of health care
3. Knowledge of medical, quality, and utilization management terminology, healthcare financing such as governmental and commercial insurance coverage.
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