HCS EXECUTIVE DIRECTOR CARE MANAGEMENT (RN) - SYSTEM CARE MANAGEMENTApply Now Email Job Job ID: EXE0014L
The System Executive Director – Care Management position reports to the System Vice President of Operations. The position is responsible for leading and overseeing the Inpatient Care Management Functions across all entities (12 hospitals), including, but not limited to, the development of a strategic plan, policies and procedures, practice, and monitoring compliance with regulations and metrics that support the practice of Care Management. The position is responsible for developing and managing the organization’s Care Management program and ensuring consistent understanding and application. The position establishes clear educational goals, competencies, and a training plan for the system. The position works with the System Vice President of Operations to ensure the Care Management program is in line with the organization’s strategic plan. The position provides recommendations on changes to the programs to ensure they remain competitive with peer organizations. The position oversees the Care Management program at each entity via a dotted line structure.
Description of Job Responsibilities:
1. Care Management - Directs the development and implementation of care management practices and policies that support the organization’s goals and ensures compliance with applicable local, state and federal laws. Oversees the care management program to include utilization management, care progression, social work, discharge planning and transitions of care. Ensures adequate staffing and orientation and training of staff. Oversees development and utilization of a standardized performance dashboard that includes key statistics that impact the success of the organization and the care of patients. Ensures all entity Directors are engaged in their entity Patient Progression Meetings. Designs, executes, monitors and evaluates recommendations for improvement. Works with entity leaders to develop standardization across the system. Collaborates with key leaders in the organization to optimize key clinical and financial outcomes within best practice, ethical, legal, and regulatory parameters. Develops relationships with key community providers to ensure common goals, consistent processes for referrals, and assist with transition planning. Works closely with a lead Physician Advisor for the system, Compliance Officer, and the VPs over Population Health and Continuing Care to develop common goals and progress toward meeting goals. Works with the Revenue Cycle department to ensure denial prevention activities are in place and to understand the causes of denials is order to assist with denials management.
2. Leading Change - Acts as a catalyst for organizational change. Influences others to translate vision into action. Brings about strategic change, both within and outside the organization, to meet organizational goals. Establishes an organizational vision and implements it in a continuously changing environment. Is open to change and new information and rapidly adapts to new information, changing conditions, or unexpected obstacles. Deals effectively with pressure and remains optimistic and persistent, even under adversity. Recovers quickly from setbacks. Formulates objectives and priorities, and implements plans consistent with the long-term interests of the organization. Capitalizes on opportunities and manages risks. Takes a long-term view and builds a shared vision with others.
3. Leading People - Leads people toward meeting the organization's vision, mission, and goals. Provides an inclusive workplace that fosters the development of others, facilitates cooperation and teamwork, and supports constructive resolution of conflicts. Encourages workforce engagement by building a commitment to excellence and by promoting the organization's vision internally and externally. Delegates responsibility, clarifies expectations and holds others accountable for achieving results related to their area of responsibility. Leads in a deliberate and predictable way and operates with transparency. Treats sensitive or confidential information appropriately. Develops the ability of others to perform and contribute to the organization by providing ongoing feedback and by providing opportunities to learn through formal and informal methods. Manages and resolves conflicts and disagreements in a constructive manner.
4. Results Driven - Exceeds organizational goals and customer expectations. Makes decisions that produce high-quality results by applying technical knowledge, analyzing problems, and calculating risks. Holds self and others accountable for measurable high-quality, timely, and cost-effective results. Delivers high-quality services and is committed to continuous improvement. Fosters a culture of safe and compassionate patient care. Makes well-informed, timely decisions, even when data are limited or solutions produce unfavorable results. Positions the organization for success by identifying new opportunities and builds the organization by developing and improving services. Leads the budgeting process. Uses cost-benefit thinking to set priorities, monitors expenditures in support of programs and policies, and identifies cost-effective approaches.
· Bachelor of Science in Nursing (BSN) from an accredited school and a license in the state of North Carolina and a Master’s degree in in Nursing, Health Care Administration, Business Administration or related field.
· Active RN required; CM certification preferred.
Professional Experience Requirements:
· Seven (7) years of executive leadership experience in a complex health system with proven results.
Knowledge, Skills, and Abilities Requirements:
· Knowledge and experience with electronic medical record (EMR) and Care Management technology, hospital coding/billing, payer contracting, and Revenue Cycle management. Advanced skills in data analysis and reporting and strategic planning. Experience in clinical system integration and a strong understanding of clinical and care management processes. Demonstrated leadership capabilities and ability to influence others. Advanced critical thinking and judgment skills. Excellent communication and interpersonal skills. Skill in collaborating with multiple departments. Robust understanding of current Medicare and Joint Commission compliance requirements. Successful team facilitation and change management experience. Proven leadership in successfully implementing new strategies. Effective collaboration with physicians, nursing, and ancillary leaders.
Primary Location: Chapel Hill, North Carolina, United States
Department: SHRD-72650-SYSTEM CARE MANAGEMENT
Shift: Day Job