Responsible for planning, organizing, directing and controlling the integrated care program, which includes case management, social services and discharge planning. The director has oversight over the Case Managers and is primarily responsible for ensuring that patient care is integrated between payers and providers, thus resulting in cost-effective quality care for all customers. This includes direction of the operational, financial and personnel Functions of the Care Management Department. Participation in the coordination and reporting of quality enhancement activities and cost-related outcomes is essential. Active involvement in evidenced based proactive activities is required for both clinical and system redesign which will enhance quality and financial outcomes. Must continually maintain up to date knowledge regarding CMS and OIG regulations and also reimbursement trends in the Managed Care arena. Must keep department employees focused as the healthcare market and managed care evolves and changes.
1. Direct the planning, implementation and daily operation of the hospital care management program and social service program in compliance with regulatory and accreditation agencies.
2. Accepts multiple management tasks to handle financial, operations, managed care and staffing issues within the Center for Integrated Care department.
3. Serves as clinical advisor to care management across the continuum of care for all payment programs. This includes participation in program development, facility network development and relations, and physician network development and relations; patient tracking across the continuum of care; and decisions regarding alternatives to acute care which consider quality and financial factors.
4. Maintains relationships with medical staff members, vice presidents, nurse managers, department manager and technical directors to support intradepartmental goals and advise on activities pertaining to outcomes, case and social management.
5. Plans, organizes, directs and controls the operational activities of the Center for Integrated Care (CIC), assuming responsibility for quality and productivity. Develops, Implements and administers departmental policies and procedures.
6. Develops and adheres to budget recommendations, administration of operating and capital budget, approval of all financial expenditures, and reconciliation of budget variances.
7. Performs personnel management activities assuring consistency of application of employee relations' policies for hiring, performance evaluation, salary adjustment, counseling and termination. Proactively promotes methodologies that positively affect patient care and staff productivity.
8. Liaison to the Information Systems Department to assure department Functions are appropriately supported with hardware and software to meet regulatory requirements and increase productivity through Midas training and updates.
9. Gains and/or expands knowledge basic income statements and balance sheets.
Position Type: Regular
Scheduled Hours per 2 week Pay Period: 80
Primary Location: TX > HOUSTON > ST LUKES MEDICAL CENTER
Education and License:
*Registered Nurse (RN)
*Minimum of seven (7) years of experience in the discipline and five (5) years leadership experienceAdditional Information
- Requisition ID: 2020-R0273675
- Schedule: Full-time
- Market: CHI St. Luke's Baylor St. Luke's Medical Center
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