Dir, Care Management
Apply NowCompany: Emory Healthcare
Location: Atlanta, GA 30349
Description:
Description
The Director, Care Management (CM) Provides oversight, direction, and strategy for Care Management within the Emory Healthcare system. The Director of CM is responsible for the day to day operations for all case management activities at the local hospital, including utilization management, transitions of care, discharge planning, payer authorization, medical necessity, and status designation. The CM Director provides clinical leadership for all CM programs by serving as an educator, role model, advocate, and change agent to enhance patient care and staff competency. The CM Director will lead local efforts and actively participate in system efforts to optimize care coordination across the continuum and ensure efficient resource utilization, quality outcomes, and maximize reimbursement. The Director of CM is responsible for all departmental performance metrics, cost effectiveness, ongoing quality, productivity and overall efficiency for the Care Management Department. The CM Director will be required to collaborate with the executive team, physicians, various leaders and staff to ensure barriers to case management performance metrics such as length of stay (LOS), avoidable days, readmissions, payer denials and other case management related outcomes are addressed timely with focus on identifying and driving performance improvement initiatives. The CM Director will be required to manage, interpret, and share data in a meaningful and actionable way. In addition, the Director, CM must collaborate with system Care Management leaders in order to create and/or enhance/maintain case management systems and standard workflows in an effort to reduce financial risk to the patient and hospital, maximize reimbursement, and ensure compliance with regulatory and compliance requirements. The Director, CM will be responsible for both chairing and participating in various committees with other leaders and staff with the common goal of process and metric improvement as well as patient satisfaction. The CM Director will ensure all CM related regulatory requirements are met. The CM Director will be instrumental in working with post-acute care providers to ensure proper utilization of services and efficient and effective transitions of care. The Director, CM will be responsible for performance management and departmental budgets. The Director, CM works collaboratively with the local Physician Advisor(s) (PA) as well as Emory Healthcare system leaders to ensure organizational engagement, understanding, and improvement with Care Management practices.
MINIMUM QUALIFICATIONS: Must have a Bachelors degree in Nursing or related field. Masters degree in Nursing preferred. Masters degree in Social Work with licensure accepted in lieu of Nursing requirements. Must have experience in an acute care hospital setting with at least 7 years in care management or comparable experience. Must have at least 3 years leadership experience. ACM or CCM certification preferred.
PHYSICAL REQUIREMENTS (Medium): 20-50 lbs; 0-33% of the work day (occasionally); 11-25 lbs, 34-66% of the workday (frequently); 01-10 lbs, 67-100% of the workday (constantly); Lifting 50 lbs max; Carrying of objects up to 25 lbs; Occasional to frequent standing & walking, Occasional sitting, Close eye work (computers, typing, reading, writing), Physical demands may vary depending on assigned work area and work tasks.
ENVIRONMENTAL FACTORS: Factors affecting environment conditions may vary depending on the assigned work area and tasks. Environmental exposures include, but are not limited to: Blood-borne pathogen exposure Bio-hazardous waste Chemicals/gases/fumes/vapors Communicable diseases Electrical shock, Floor Surfaces, Hot/Cold Temperatures, Indoor/Outdoor conditions, Latex, Lighting, Patient care/handling injuries, Radiation, Shift work, Travel may be required. Use of personal protective equipment, including respirators, environmental conditions may vary depending on assigned work area and work tasks.
Additional Details
Emory is an equal opportunity employer, and qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, protected veteran status or other characteristics protected by state or federal law.
Emory Healthcare is committed to providing reasonable accommodations to qualified individuals with disabilities upon request. Please contact Emory Healthcare's Human Resources at careers@emoryhealthcare.org. Please note that one week's advance notice is preferred.
The Director, Care Management (CM) Provides oversight, direction, and strategy for Care Management within the Emory Healthcare system. The Director of CM is responsible for the day to day operations for all case management activities at the local hospital, including utilization management, transitions of care, discharge planning, payer authorization, medical necessity, and status designation. The CM Director provides clinical leadership for all CM programs by serving as an educator, role model, advocate, and change agent to enhance patient care and staff competency. The CM Director will lead local efforts and actively participate in system efforts to optimize care coordination across the continuum and ensure efficient resource utilization, quality outcomes, and maximize reimbursement. The Director of CM is responsible for all departmental performance metrics, cost effectiveness, ongoing quality, productivity and overall efficiency for the Care Management Department. The CM Director will be required to collaborate with the executive team, physicians, various leaders and staff to ensure barriers to case management performance metrics such as length of stay (LOS), avoidable days, readmissions, payer denials and other case management related outcomes are addressed timely with focus on identifying and driving performance improvement initiatives. The CM Director will be required to manage, interpret, and share data in a meaningful and actionable way. In addition, the Director, CM must collaborate with system Care Management leaders in order to create and/or enhance/maintain case management systems and standard workflows in an effort to reduce financial risk to the patient and hospital, maximize reimbursement, and ensure compliance with regulatory and compliance requirements. The Director, CM will be responsible for both chairing and participating in various committees with other leaders and staff with the common goal of process and metric improvement as well as patient satisfaction. The CM Director will ensure all CM related regulatory requirements are met. The CM Director will be instrumental in working with post-acute care providers to ensure proper utilization of services and efficient and effective transitions of care. The Director, CM will be responsible for performance management and departmental budgets. The Director, CM works collaboratively with the local Physician Advisor(s) (PA) as well as Emory Healthcare system leaders to ensure organizational engagement, understanding, and improvement with Care Management practices.
MINIMUM QUALIFICATIONS: Must have a Bachelors degree in Nursing or related field. Masters degree in Nursing preferred. Masters degree in Social Work with licensure accepted in lieu of Nursing requirements. Must have experience in an acute care hospital setting with at least 7 years in care management or comparable experience. Must have at least 3 years leadership experience. ACM or CCM certification preferred.
PHYSICAL REQUIREMENTS (Medium): 20-50 lbs; 0-33% of the work day (occasionally); 11-25 lbs, 34-66% of the workday (frequently); 01-10 lbs, 67-100% of the workday (constantly); Lifting 50 lbs max; Carrying of objects up to 25 lbs; Occasional to frequent standing & walking, Occasional sitting, Close eye work (computers, typing, reading, writing), Physical demands may vary depending on assigned work area and work tasks.
ENVIRONMENTAL FACTORS: Factors affecting environment conditions may vary depending on the assigned work area and tasks. Environmental exposures include, but are not limited to: Blood-borne pathogen exposure Bio-hazardous waste Chemicals/gases/fumes/vapors Communicable diseases Electrical shock, Floor Surfaces, Hot/Cold Temperatures, Indoor/Outdoor conditions, Latex, Lighting, Patient care/handling injuries, Radiation, Shift work, Travel may be required. Use of personal protective equipment, including respirators, environmental conditions may vary depending on assigned work area and work tasks.
Additional Details
Emory is an equal opportunity employer, and qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, protected veteran status or other characteristics protected by state or federal law.
Emory Healthcare is committed to providing reasonable accommodations to qualified individuals with disabilities upon request. Please contact Emory Healthcare's Human Resources at careers@emoryhealthcare.org. Please note that one week's advance notice is preferred.