Director of Care Management
Women & Infants - Care Management Job ID: 08410-x1552-002
Under the dual supervision of the Women & Infants Hospital Senior Vice President of Patient Care Services and System Director of Care Management, the Director of Care Management for Women & Infants Hospital is responsible for the day-to-day operations of the Care Management department at WIHRI including the directing, planning, implementing and continuously improving of all activities of the Care Management program. Oversees the functions associated with care facilitation, utilization review and the movement of patients throughout the hospital and organization continuum while optimizing effective and efficient utilization of clinical resources. This is accomplished through interdisciplinary planning related to clinically appropriate and fiscally responsible inpatient resource utilization, interdisciplinary plans of care, discharge planning, safe transitions to post-discharge care and collaboration with the Accounting Care Organization (ACO). Oversees the development and execution of processes and procedures to establish and promote compliance, satisfaction, quality and performance standards. Provides leadership, expertise, training and coaching to department staff to develop strong technical skills in care management along with promoting strong communication and problem solving.
Bachelor of Science Degree in Nursing required. Masters degree in Nursing or related field Required within 2 years of hire, if not already obtained. Five to seven years of acute care hospital environment experience required with two years in Care Management Leadership experience required. Current RN License in Rhode Island required, Certification in Care Management preferred or upon hire, will obtain Certification in Care Management within one year of hire Certified Professional in Health care Quality (CPHQ) encouraged, Basic Life Support (BLS) certification required. Ability to establish priorities, meet deadline, and maintain proper productivity. Ability to form positive, collaborative relationships with hospital staff, physicians, patients, families and post-acute providers. Ability to problem solve in a proactive, creative manner, using sound judgment based on factual information and clinical knowledge. Excellent leadership skills and supervisory experience preferred. Ability to lead and actively participate in multidisciplinary teams. Knowledge and training in multiple computer systems required to perform position responsibilities (i.e. Cerner, InterQual, 3M, Microsoft Office, etc.). Ability to work independently or within a team structure. Excellent interpersonal skills and communication style. Working knowledge of regulatory, Medicare, Medicaid and third party payer compliance requirements.