Director, Care Coordination - WellStar Spalding Regional Hospital
The Director of Care Coordination will work closely with the VPMA, CFO and other members of the senior leadership team to build strategies that are aligned with current performance and hospital goals and vision for the care management program, timely patient throughput, appropriate care and utilization, safe disposition planning as well as utilizing data and analytics to drive departmental performance. The director will be responsible for adherence to the system Utilization Management Plan and care coordination policies and procedures, Care Coordination standards of care, CMS and other Payer regulations, Joint Commission regulations, and will ensure that the system strategic vision is fully integrated into the culture of the care coordination program. Will align closely with physician and share performance data with individual physicians and service lines.
The Director of Care Coordination is responsible for the day to day operations for all case management activities across the hospital, including utilization management, safe transitions planning, financial performance related to payer authorization processes, avoidable day tracking and reporting, medical necessity, ongoing quality, productivity and overall efficiency for case management processes. This director will ensure that the system standardize care coordination processes are implemented and followed always. As part of the role, the director will collaborate with physicians and other departmental leaders and staff to ensure that barriers to care coordination outcomes such as length of stay (LOS), avoidable days, readmissions, payer denials and other care coordination related outcomes are address timely with attention given to identifying root causes and driving performance improvement initiatives that ensures performance is aligned to targeted goals. Must be able to manage, interpret and share data.
Other duties of the director include creating and enhancing current tools, methodologies, recruiting practices, and personnel development processes. Plays a key role in the retention, professional development and performance review of staff, including mentoring, coaching, performance appraisals and recruiting as well as departmental budgets.
The director participates in committees with the hospital medical staff and other leaders to address and solve issues that drive variation from goals. Is also responsible for collaborating with other key departments that drive throughput delays and work to jointly eliminate those barriers.
Required Minimum Education: BSN graduate from an accredited school of Nursing with a current RN license in the State of Georgia and a Master’s Degree required. (MPH, MBA or MHA Preferred). Or Masters in Social Work (LMSW or LCSW) from an Accredited School, required. Licensure in SW required.
Required Minimum Experience: Requires 3 to 5 years management experience of a multidisciplinary staff in the field of case management or quality and patient safety with at least 6-8 years of experience in a hospital environment is required. Strong supervisory experience showing proven track record; Clinical Practice/Experience is required in licensed field; Experience in case management and/or social work. Strong employee engagement skills demonstrated by results
Required Minimum Skills: Excellent organizational, verbal and written communication skills. Independent and self-directed. Strong ability to manage data - interpret and analyze. Ability to handle and manage change, perform critical analysis, and mentor and develop direct reports. Knowledge of management practices and procedures, budgetary process and development and administrative and operational process.
WellStar Health System - the largest health system in the state of Georgia and one of the largest not-for-profit health systems in the country. WellStar is comprised of 11 hospitals, 250 medical office locations, 25,000 employees and over 3,200 medical staff members. www.wellstar.org
Employer will assist with relocation costs.
Internal Number: 2018-18110
About WellStar Health System
WellStar Health System, the largest health system in Georgia, is known nationally for its innovative care models that are focused on quality improvement and increased access to healthcare. Staying ahead of the technology curve has enabled WellStar to be a leader in both the diagnosis and treatment of an extensive array of health conditions. Serving a diverse population, WellStar consistently looks at total patient wellness and works to ensure that all systems support that focal point.
Specialists and primary care providers work in a multi-disciplinary environment with 25,000 team members throughout the System’s 11 hospitals, 250 medical office locations, outpatient centers, health parks, nursing centers, and other entities, including hospice, homecare, and a pediatric center. WellStar places enormous value on quality and safety by working through a patient-centered model of care.