DIRECTOR CARE COORDINATION

Director Care CoordinationClick Here to Apply OnlineJob DescriptionLocation : Carney HospitalPosted Date : 1 / 24 / 2024Job Type : Full TimeDepartment : 0401.

70205 CARN Case Management Job Summary About Steward Health CareNearly a decade ago, Steward Health Care System emerged as a different kind of health care company designed to usher in a new era of wellness.

One that provides our patients better, more proactive care at a sustainable cost, our providers unrivaled coordination of care, and our communities greater prosperity and stability.

As the country's largest physician-led, minority-owned, integrated health care system, our doctors can be certain that we share their interests and those of their patients.

Together we are on a mission to revolutionize the way health care is delivered - creating healthier lives, thriving communities and a better world.

Steward is among the nation's largest and most successful accountable care organizations (ACO), with more than 5,500 providers and 43,000 health care professionals who care for 12.

3 million patients a year through a closely integrated network of hospitals, multispecialty medical groups, urgent care centers, skilled nursing facilities and behavioral health centers.

Based in Dallas, Steward currently operates 33 hospitals across Arizona, Arkansas, Florida, Louisiana, Massachusetts, Ohio, Pennsylvania, and Texas.

TITLE : Director Care Coordination JOB CODE : CAR-0118DEPARTMENT : Case Management FLSA STATUS : ExemptREPORTS TO : CFO / CMODATE : 3 / 14 / 17 KEY RESPONSIBILITIES : Evaluates, develops, implements and monitors utilization and case management and activities to promote quality and cost effective results.

Collaborates with Social Work, Q.I. Nursing, Fiscal, Managed Care and other clinical departments as well as physicians, hospital administration, community agencies, and third party payers with an emphasis toward providing excellent patient care across the care continuum within a fiscally responsible framework.

Fiscal Responsibilities - reporting to Chief Financial OfficerDirects member's need for case management services, including verifying eligibility, benefit and insurance limitations, medical necessity and appropriateness of referralReviews case management referrals by communication directly with physicians, HMO's Medical Director, hospital staff and other appropriate ancillary providers on a regular basisAssesses quality of contracted vendors including quality outcomes, patient and physician satisfaction, cost and service levelsSupervises the tracking of all referral and DME servicesAttends leadership meetings, participates in committees, identified and manages department priorities, plans budget and reviews staff Clinical Responsibilities - reporting to Chief Medical OfficerResponsible for supervising and / or performing case management, utilization review, quality assurance, and discharge planningResponsible for assisting CM's in the assessment, identification, and awareness of services available to patients and families at the time of dischargeResponsible for assisting CM's in performing admission and concurrent review, and retro-review of all inpatients conforming to CMS requirementsCoordinates Issuance of non coverage letters by CM's at time of discharge when applicablePerforming surveillance and data collection as directed for trend recognition and development of effective action plansMaintains compliance with state and federal guidelines as well as Joint Commission and CMS CoP standards Facilitates the Provision of information by CM's in response to payer queriesParticipates in Continuing Education and other appropriate learning to maintain professional growthUtilizes Interqual criteria and standards for concurrent review requirements in supervising CM'sPrepares and distributes 3 day LOS reports daily to SLTDaily participation in morning rounds with house staff, CM's and hospitalists in conjunction with the CMOAnalyzes and presents clinical and utilization data to physician groupsEducates clinical staff on alternative to acute care including new technology / alternatives for high tech home health, extended care and disease management initiatives.

Supervises staff and provide direct services to inpatient units Demonstrates respect and regard for the dignity of all patients, families, visitors, and fellow employees to ensure a professional, responsible, and courteous environment.

1. Commits to recognize and respect cultural diversity for all customers (internal and external). 2. Communicates effectively with internal and external customers with respect of differences in cultures, values, beliefs and ages, utilizing interpreters when needed.

• Performs other duties as assigned REQUIRED KNOWLEDGE & SKILLS : Previous supervisory experience required Good finance / budgeting skillsAbility to work independently and take initiativeGood judgment and problem solving skillsStrong communication, interpersonal and organizational skillsHigh level of confidentiality EDUCATION / EXPERIENCE / LICENSURE / TECHNICAL / OTHER : Education : Graduate of an NLN accredited school of nursing;
• Bachelor's degree in nursing required and MS would be desirable Experience : 3 to 5 years inpatient care management experience in an acute care setting, could be rehab or chronic care hospitals;

experience with Medicare regulations; experience with patient advocacy and quality improvement programs is preferred; union environment experience would be a plus.

Certification / Licensure : RN licensure in MA Software / Hardware : Other : Steward Health Care is proud to be a minority, physician owned organization.

Diversity, equity, inclusion and belonging are at the foundation of the care we provide, the community services we support and all our employment practices.

We do not discriminate on the grounds of race, color, religion, sex, national origin, age, disability, veteran status, sexual orientation, gender identity, and or expression or any other non-job-related characteristic.

Application InstructionsPlease click on the link below to apply for this position. A new window will open and direct you to apply at our corporate careers page.

We look forward to hearing from you