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Director of Care Management

Execu|Search Type Full time Posted 1/18/2014
Salary $150,000-$175,000 Starts 4/20/2014
CT - Connecticut (All) - Stamford Referral - n/a -    
Director of Care Management
Location: Stamford, CT
Salary: $150,000-$175,000
Experience: 6.0 year(s)
Job Type: Full-Time
Job ID: J121931

About the Opportunity

A major hospital in Connecticut is now seeking a Director of Care Management. In this role, the Director of Care Management is responsible for leading, coordinating and managing the quality, safety and effectiveness of patient care transitions from and related to, the acute care setting. These include transitions to ambulatory, post-acute, and community settings. The Director will lead a team that directs and facilitates relationships among hospital, ambulatory, and community based providers for seamless continuity of care, including but not limited to physician offices, clinics, hospices, skilled nursing facilities, home health agencies,LTACs, and other post-acute and community entities.

Company Description


Job Description

Responsibilities include:

  • Develop programs and have processes in place to anticipate the needs of patients and families, standardizing the approach to communication and processes to improve outcomes and satisfaction
  • Develop focused initiatives to accomplish the specific objectives of the Care Management Department as well as the overall goals
  • Collaborate with palliative care, hospice,hospitalistsand other providers in the care continuum to maximize effectiveness of the team
  • Support clinical (nursing and physician) peer review activities by working with the care management staff and intervening with medical staff members as necessary
  • Ensure that the hospital receives all payments that it is entitled to for patient treatment through active advocacy and appeal; diligently appeal concurrent and retrospective denials both verbally and in writing through the resources in the department
  • Collaborate with Clinical Chairs, Division Directors, Medical Directors and administrative leaders to continue building systems and processes to improve medical management, including participation in the development of pathways, protocols, and referral management processes
  • Provide ongoing education to medical staff, both attending physicians and residents, on changes in medical necessity criteria
  • Serve as chair or member of key committees as requested by theSVPMedical Affairs or VP Quality
  • Provide leadership for application of evidence based practices for management, aggregation, and analysis of care coordination, quality and safety data involving publicly reported data, data registries, and institutionally-specific variables as agreed with the VP Quality
  • Leading, coordinating and managing the quality, safety and effectiveness of patient care transitions from and pertinent to the inpatient setting
  • This encompasses transitions both within the hospital and health system as well as in between the system and the community at large
  • This includes admission and discharge planning and enabling disease and resource management efforts
  • Other duties and projects as needed
Required Skills
  • Current Connecticut Registered Nurse License
  • Bachelors Degree in a related field
  • A minimum of five years' recent experience in complex case management, long term stays, including nurse assisted case management, utilization management, and disease management
  • Certified Case Manager (CCM) or certification in care management related discipline
  • Excellent organizational, communication, interpersonal and public speaking skills
  • Experience with personnel management in including recruitment, job description development and disciplinary processes
  • Experience with developing, administering, and monitoring budgets
  • Certificate inRHIA,RHIT,MRAor ART
  • Experience with performance improvement including CMS andTJCcore measures
  • Prior experience working with multidisciplinary group practice and/ or community based programs and facilities$
Desired Skills
  • Masters Degree in Healthcare Administration