Director of Care Coordination

Shift: Days

Work Hours: 8am- 4:30pm (Monday-Friday)

*This position will be onsite only**

Employment Type: Full Time

**Prefer candidates with Masters degree***

Primary Purpose

Directs the clinical and financial operations of a Care Management system. Provides hospital-wide leadership through effective managerial and educational direction in the areas of Care Coordination Operations, Resource Management, timely movement of patient through a continuum, DRG Financial Analysis, Change Management, Managed Care, Guidelines/Protocols, Clinical Documentation and Systems Improvement.

MINIMUM SPECIFICATIONS

Education

• Must have a bachelor's degree in nursing with a MPH, MBA or master's degree in nursing -or- Must have a master's degree in social work with LMSW or LCSW licensure.

Experience

• Must have eight years of progressively responsible experience in an acute care environment to include six years of Case Management experience.
• Must have a minimum of five years of experience as a manager or director of Care/Case Management experience in a fast paced, complex environment.

Equivalent Education and/or Experience

• None

Certification/Registration/Licensure

• Must have and maintain certification in Case Management or obtain within six months of hire/placement in the job. Certification options are Certification in Case Management (CCM), Accredited in Case Management (ACM) or American Nurses Credentialing Center (ANCC).

RN Only:

• Must have either a current RN license or valid temporary permit with the Texas Board of Nursing; or, valid Compact RN license.

Social Work Only:

• Must be licensed by the Texas State Board of Social Work.

Skills or Special Abilities

• Must have excellent verbal and written communication skills in working with a diverse population of physicians, nurses, and support staff.
• Must demonstrate ability to use a personal computer including knowledge of Microsoft office products.
• Must demonstrate multidisciplinary approach to clinical improvement.
• Must demonstrate prior fiscal management of department operations.
• Must demonstrate knowledge of Managed Care concepts and strategies.
• Must demonstrate knowledge of DRG reimbursement system.
• Must be capable of converting DRG and Physician Practice pattern data into information which quantifies impact on cost and quality.
• Must be able to implement new programs and problem-solving mechanisms.
• Must demonstrate good communication, analytical and writing skills.
• Must demonstrate excellent knowledge of Medicare/Medicaid and Third Party admission and concurrent review criteria.
• Must demonstrate knowledge of benchmarking and best practice methodologies.
• Must demonstrate ability to implement and initiate workload changes and set priorities accordingly.
• Must demonstrate knowledge of Care Management/Practice Guideline concepts and application methodology, trending, analyzing and reporting variance data.
• Must demonstrate effective human resource and change management skills.
• Must have effective leadership skills and be capable of motivating, recruiting and educating staff.
• Must be able to demonstrate knowledge of Parkland policies, structure, procedures and mission within three months of employment.
• Must demonstrate patient centered/patient valued behaviors.

Responsibilities

• Directs the day-to-day activities of the Care Coordination department to ensure hospital-wide leadership through effective managerial and educational direction in the areas of Care Coordination Operations, Resource Management, DRG Financial Analysis, Change Management, Managed Care, Guidelines/Protocols, Clinical Documentation and Systems Improvement.
• Oversees the direction of Care Coordination staff to ensure efficient and effective operations. Conducts staff meetings on a regularly scheduled basis to communicate changes, update information, keeps staff informed on new requirements and resolve issues. Evaluates department policy, procedures and processes to maintain efficient work flow.
• Develops processes to ensure that Care Coordination and Nursing function together as a health care delivery team. Models excellence in nursing through the utilization of advanced concepts in the areas of assessment, diagnosis, planning, implementation, and evaluation of problems in a variety of clinical settings. Collaborates with physicians and clinical nurses in the development guidelines/protocols. Assesses and evaluates the effectiveness of the Care Coordination program continuously and plans interventions as needed. Participates in a collaborative fashion in the development of standards and/or protocols ensuring that national specialty standards are research findings drive clinical practice.
• Educates nursing and medical staff, as well as other health care providers on the concept of care coordination including compliance and financial exposures. Orients Care Coordinators to the role as well as provides ongoing education as appropriate. Assists in the education of staff regarding processes and systems that requires Care Coordination involvement. Develops working relationships with community resources that link with patient population needs and optimal continuum flow.
• Responsible for effective fiscal management of the department. Prepares the annual budget, incorporating Parkland and Care Coordination department goals. Periodically analyzes revenue and losses, revising budget, staffing, billing, facility access or other practices to accommodate cost effective findings. Ensures informed use of department resources through clear policies including equipment, supplies, personnel hiring/training practices and service utilization. Administers the operating, capital and payroll budgets to ensure that the department has the necessary funds to carry out the goals and objectives that have been established for the department. Complies with departmental budget requirements to control spending and develop the annual budget request.
• Serves as an expert in the Care Coordination model by providing consultation, education, and information to health care consumers, health care providers, organizations and legislative bodies. Collaborates with and serves as a resource to physicians and expert clinicians in the development and implementation of guidelines/protocols. Serves as resource to care coordinators in dealing with difficult patient problems. Serves as a patient and family advocate and as a resource in cases that present ethical dilemmas.
• Utilizes current research to guide development of guidelines and changes in health care delivery. Collects data on patient outcomes, length of stay, and patient charges on selected patient types.
• Serves as an agent of change. Presents an attitude of willingness to accept change and is supportive and positive toward staff during times of transition. Serves as an initiator and facilitator for planned change in the development of programs and activities which enhance the quality of nursing care.
• Maintains awareness and participates in Continuous Quality Improvement (CQI) to ensure a safe patient environment. Adheres to all Parkland policies and procedures including but not limited to the hospital Code of Conduct and Corporate Compliance Program, safety rules, Joint Commission standards, Texas Department of Health and Human Services regulations and other regulatory agencies. Provides methodology for dissemination of information providing opportunities for discussion of division problems, and orientation of new projects or procedures, as assigned.