Director, Care Management

Summary:

Candidate for the Director of Care Management role may reside in one of the following cities: Irving, TX; Corpus Christi, TX; San Antonio, TX; Beaumont, TX; Tyler, TX; Longview, TX; Texarkana, TX; Alexandria, LA; Shreveport, LA; or Lake Charles, LA.

The Director of Care Management reports to the System Director of Care Management and in partnership with the CHRISTUS Clinical Excellence Division and other health system leaders, is responsible for assisting in the creation and delivery of strategies focused on improving operations in the pursuit of clinical excellence. The incumbent will do so by participating in evaluation, planning and execution of the full scope of Case Management functions and improvement opportunities to form a comprehensive model of care across the continuum of health care services. He or she will work collaboratively with hospital Case Management Directors to evaluate, design, and implement strategies to enhance case management, social work, and utilization review functions and evaluate outcome measures associated with each initiative. These strategies will directly impact quality, cost efficiency, and improve patient care.

• Build strong relationships throughout the multi-hospital system to help support and maintain consistency with system-wide initiatives.
• Translates organizational goals into action plans with outcome metrics for assigned department(s); Implements initiatives to meet strategic expectations.
• Implement a high-reliability approach to reduce wasteful variation in practice and eliminate the consumption of unnecessary clinical resources while improving clinical and financial outcomes across the care continuum
• Works collaboratively with system, regional, and entity leaders and physicians to develop and implement best practices for Case Management teams and programs that maximize appropriate resource utilization and care transitions.
• Work collaboratively with hospital Case Management leaders to meet strategic and operational excellence goals including cost initiatives, and delivery of high-quality outcomes.
• Guides teams in compliance with state and federal regulations.
• Develops and oversees the execution of policies and procedures that direct the practices and workflow of the Care Management function.
• Implements plans to minimize clinical denials by working collaboratively with key partners in the system office, regions, and health system.
• Implements strategies to consolidate and standardize case management/utilization review efforts and models across the health system to positively impact length of stay, observation utilization, care transitions, and other case management impacted metrics.
• Assists teams in evaluation and implementation of technology to enhance the work of case management and utilization review.
• Works in partnership with the Population Health team to streamline transitional care processes.
• Assists in leading the Care Management Operations Council and health system Care Management Council as needed and provides leadership support for the committees and members of the group.
• Direct supervision of case management/utilization review functions as assigned.

Requirements:

• Bachelor's Degree in nursing or social work required
• Master's in healthcare or business-related field preferred
• ACM or CCM certification preferred
• Minimum of 5 years of hospital case management and utilization review experience.
• Minimum of 3 years of hospital case management/utilization review leadership experience. Multiple site experience preferred.
• Licensed as a Social Worker or Registered Nurse 

Full Time