Director-Care Management Operations

Responsibilities

• Oversees analysis of length of stay, progression of care and utilization trends and works with hospital leadership to address and solve problems.
• Oversees the acute care function and policy development of care management including care management, Social Services and care coordination, compliance and regulatory standards.
• Manages the Care Management operations staffing and budget in designated region for both inpatient and ambulatory care management functions and coordinates with peer Care Management leadership throughout the System.
• Identifies care management programming needs which require care management across the continuum. Collaborates with regional leadership team members on the operations of these programs.
• Works with leadership in the WellSpan hospital, Medical Group and Post-Acute services to coordinate care management activities across the continuum of care.
• Learns and leads strategic goals/ priorities that supports business transformation, population health functions and care coordination in collaboration with the appropriate leadership members.
• Oversees staffing levels, selects and assigns staff, evaluates performance, evaluates/tests competencies (as applicable), provides orientation, training and continuing education of staff, and initiates or makes recommendations for personnel actions.
• Develops budget(s) for the department/unit/entity and allocates funds within budget(s) to accomplish objectives. Monitors variance against budget(s).
• Captures and integrates services within the department/service line/entity, with other departments/service lines/entities, and with the System's primary functions.
• Participates in the selection of outside services (if needed).
• Continuously assesses and improves the department/service line/entity/System's performance. Maintains appropriate quality control/assessment programs (if applicable).
• Develops and initiates educational programs regarding utilization management principles, care management and social work.

Qualifications

• Minimum Education: Masters Degree Required
• Work Experience: 2 years Relevant experience.
• Required Licenses: Licensed Registered Nurse Upon Hire Required; Licensed Social Worker Upon Hire Preferred; Basic Life Support Upon Hire Required.
• Preferred or Certified in specialty: Upon Hire Preferred.
• Required Courses and Training: Utilization management, case management, or clinical nursing specialty Upon Hire Preferred and Certification in specialty Upon Hire Preferred.