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Director, Care Management - Inpatient

Company: JPS Health Network
Location: Fort Worth
Posted on: January 17, 2022

Job Description:

The Director, Inpatient Care Management is responsible and accountable for operational direction, management, and oversight to the Inpatient Care Management teams including care facilitation, utilization management, case management, and transitions of care. The Director is responsible for developing systems and processes for care/utilization management and discharge planning at the hospital level. The Director evaluates and ensures that hospital resources are used appropriately and effectively. The Director oversees the collection, analysis, and reporting of financial and quality data related to utilization management, quality improvement, and performance improvement. The Director promotes interdisciplinary collaboration, fosters teamwork, and champions service excellence.

Typical Duties:
Develops and implements case management programs, including utilization review, discharge planning, and transitions of care.
Collaborates with executive and clinical leadership to develop and promote system-wide improvement strategies and multidisciplinary team projects through the use of evidence-based solutions for care management and utilization review.
Plans, directs, and oversees all aspects of the inpatient case management program including comprehensive assessment, identifying training and development opportunities, performance improvement, and change management.
Acts as liaison to facilitate communication and collaboration between all care partners (physicians, hospitalists, outpatient care managers, nurses, finance, community resources, etc.)
Develops and maintains effective working relationships with other department directors concerning mutual strategic goals that ensure growth and development of the case management program through benchmarking for best practices, networking, quality management, and other activities as needed.
Develops and manages budget performance and executes appropriate strategies to manage cost and improve quality of care and services. Analyzes patterns of variances and implements strategies to resolve findings.
Stays abreast of regulatory requirements impacting inpatient case management and informs, educates, and advises medical staff, clinical and executive leadership.
Identifies and implements technology support solutions for improved continuity of care, risk stratification, and use of data to measure the effectiveness of care interventions with high-risk patients.
Creates and analyzes inpatient care management reports and dashboards to track productivity, reduction in the total cost of care, access to care, care gap closure related to HEDIS measures, and health outcomes.
Monitors, evaluates, and redesigns institutional and departmental practices and processes to meet or exceed all regulatory and accrediting agency requirements.
Provides consultation and/or oversight to teams addressing process redesign and alignment with national best practices, external regulatory requirements, and payers.
Performs other job-related duties as assigned.

Required Education and Experience:
Master's Degree in Nursing, Social Work or related field from an accredited college or university.
4 plus years of experience in Acute Care Case Management, Care Management, and Utilization Management, and/or related experience.
3 plus years of supervisory/management experience.
Preferred Education and Experience:
5 plus years of experience in Acute Care Case Management, Care Management, and Utilization Management.
4 plus years supervisory experience
Required Licensure/Certification/Specialized Training:
Current RN licensure by the Board of Nurse Examiners for the State of Texas or proof of reciprocity of licensure between the State of Texas and another state.
Licensed Master Social Work (LMSW) through the Texas State Board of Social Work Examiners.
Preferred Licensure/Certification/Specialized Training:
Case Management Certification-ACM or CCM

Keywords: JPS Health Network, Fort Worth , Director, Care Management - Inpatient, Executive , Fort Worth, Texas

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