Director Care Coordination

About the Role

Banner Health’s Behavioral Health Utilization Review Department (BHURD) seeks an experienced RN or Social Worker to lead a dynamic, centralized team dedicated to optimizing patient care through strategic utilization review. This role offers the opportunity to shape operational excellence in behavioral health services in a supportive, forward-thinking environment where flexibility and teamwork are valued alongside clinical expertise.

Location: Banner Estrella Medical Center. This is an exempt role with a Monday–Friday schedule and a rotating on-call component shared with other facility Directors.

Responsibilities

• Develop and implement care and utilization management programs and services.
• Provide leadership, direction, and support for Care Coordination Services to achieve quality outcomes, reduce costs, and enhance patient, physician, and employee satisfaction.
• Oversee facility/entity-specific patient outcomes related to patient goals, contractual deliverables, effective transitions of care, internal alignment initiatives, and stakeholder relationships.
• Plan, direct, and monitor the case and utilization management program(s).
• Ensure development of Care Coordination services aligns with the organization’s strategic plan.
• Design and implement processes to ensure appropriate care coordination in accordance with regulatory and safety standards.
• Lead or facilitate task forces, teams, and councils to plan, implement, and coordinate post-acute programs and services.
• Provide strategic direction for multidisciplinary process improvement activities, including establishing performance measures for clinical, operational, financial, and satisfaction outcomes.
• Direct the collection, analysis, and presentation of data on utilization patterns and program outcomes.
• Oversee personnel actions, including recruiting, hiring, salary determinations, training, and evaluations.
• Participate in the development of Care Coordination goals and objectives in accordance with company standards.
• Establish and oversee financial and capital resources for Care Coordination services, including monitoring operating revenue and expenses, and developing cost control programs.
• Develop and implement strategies to ensure appropriate reimbursement from external customers.
• Oversee department budget(s) in alignment with corporate goals and objectives, ensuring annual budgetary targets are met.
• Assess and improve patient satisfaction as measured by survey scores.

Requirements

• RN: Bachelor’s of Science in Nursing (or related field) and a current Registered Nurse (R.N.) license in the state of employment.
• Social Worker: Master’s degree in Social Work and Licensed Master Social Worker (LMSW) (or equivalent) or Licensed Clinical Social Worker (LCSW). An equivalent license applies to states that do not recognize LMSW.
• Three years of acute care experience with an age-specific patient population in the area of responsibility.
• Minimum of three years of progressive leadership experience.
• Demonstrated flexibility in responding to the needs of multiple constituencies with a service-oriented philosophy.
• Strong skills in problem analysis, project management, contract negotiation, conflict resolution, and oral/written presentation.
• Working knowledge of utilization management, care management, regulatory standards, and reimbursement across the continuum of care.

Preferred Qualifications

• Six years of experience in case management in an acute care setting.
• Two years of leadership experience.
• Certified Case Manager (CCM) certification.
• Managed care experience.

Benefits

This opportunity includes the option to participate in a variety of health, financial, and security benefits. The position may also be eligible for Banner Health’s Management Incentive Program as part of the Total Rewards package.

About the Facility

Banner Estrella Medical Center is a 353-bed acute care hospital serving the fast-growing communities of west Phoenix. Opened in 2005, the facility is fully electronic, featuring electronic medical records, computerized physician order entry, digital radiography, and sophisticated ICU monitoring. The hospital has been recognized as one of the "ten most innovative hospitals in the country" by Newsweek Magazine and is listed among Phoenix’s Best Hospitals by U.S. News and World Report. The environment is designed to promote healing, incorporating therapies such as pet therapy, aromatherapy, spiritual care, and Reiki Therapy.