Director Care Management

Job ID: J124428
Company: West Penn Allegheny Health System
Location: Pittsburgh, PA, United States
Facility: Allegheny General Hospital
Full/Part Time: Full time
Job Type: Regular
Posted at: Jul 10, 2018

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Description

GENERAL OVERVIEW:

Provides operational and strategic leadership for Hospital/facility Care Management Department.  Collaborates with nursing and clinical leaders to assure smooth patient care progression and effective outcomes and care transitions.  Directs collaborative efforts with physicians, revenue cycle and payor teams, and patients and their families to incorporate evidence based practices and appropriate use of resources.  Communicates effectively with Hospital leadership in the development of day to day and strategic goals. 

ESSENTIAL RESPONSIBILITIES:

  • Establishes systems to facilitate entry of patients into appropriate bed, unit, and level of care.  Evaluates effectiveness and leads improvement efforts within Hospital to assure appropriate access and level of care assignment.
  • Develops and implements strategies with internal and external providers to ensure placement of patients in the right level of care at the right time, predictably.  Participates in collaborative forums to assure consistent practice.
  • Studies and implements the care management model and structure to achieve sustainable length of stay, resource utilization, and clinical outcomes for patients over time.  Responsible for designing and implementing improvement strategies for the care model on an ongoing basis.
  • Establishes a development plan for the department, with a focus on effective use of resources, inter-professional collaboration, and coordination with chronic disease, transitional planning, and specialty teams.
  • Directs and oversees all activity related to referral management.  Leverages Epic and Careport/Allscripts data to assess effectiveness.  Collaborates closely with Highmark Home and Community Services to establish  and/or enhance post-acute network partnerships.
  • Creates an environment that embraces cultural diversity and recognition that we are stronger as an interdisciplinary team when we embrace our differences.
  • Promotes an environment of transparency with the use of visual management boards on nursing units.
  • Promotes staff participation in the annual NDNQI nurse satisfaction survey. Additionally, coaches managers on identified opportunities from nurse satisfaction survey results.
  • Actively participates in review and identification of opportunities of nurse quality indicators as measured by NDNQI at individual department level partnering with nurse managers.
  • Benchmarks AHN-SVH performance against national best practices.
  • Pursues sharing of best practices through publication, presentation at conferences and networking with other AHN leaders throughout the system.
  • Performs large scale project management independently.
  • Implements and monitors initiatives to recognize, reward and incentivize staff.
  • Actively participates in the development and communication of nursing's shared vision.
  • Seeks out learning opportunities to enhance professional growth and development. Creates and updates personal professional development plan annually. Minimally meets state requirements for continuing education.
  • Identifies opportunities for journal publications for self and staff.
  • Participates in a research project.
  • Lead and support evidence based projects & nursing research by assisting in the identification of opportunities to incorporate the scientific method into nursing practice.
  • Financial stewardship: monitors, controls, and is accountable for maintaining departmental costs within budgeted allocations.
  • Builds trusting and collaborates relationships with other hospital departments, patient care units, ambulance services, medical staff, patient and families, law enforcement officers, clergy, morticians, media and other health facilities.
  • Utilizes a transformational leadership style to facilitate effective change management principles to drive needed improvements.
  • Reviews patient satisfaction data and findings from Press Ganey and assists in coaching managers formulate improvement plan.
  • Analyzes clinical service areas for operational effectiveness, using dashboards and other data sources.
  • Oversees and ensures that standards of care are maintained relative to quality management, utilization review, and discharge planning.
  • Accountable to ensure ongoing development and operation of Shared Governance model in all departments.
  • Serves as a consultant for nurse managers and medical staff on patient care or nursing issues assisting with interpretation of Health Center policies to ensure patient needs are met.
  • Through research and planning ensures patient care is delivered in accordance with the professional standards for nursing practice and is evidenced based.

QUALIFICATIONS:

Minimum

  • MSN degree or equivalent education and years of experience
  • National Certification required within 1 year of taking position
  • PA State Registered Nurse License

Preferred

Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities, and prohibit discrimination against all individuals based on their race, color, religion, sex, national origin, sexual orientation/gender identity or any other category protected by applicable federal, state or local law. Highmark Health and its affiliates take affirmative action to employ and advance in employment individuals without regard to race, color, religion, sex, national origin, sexual orientation/gender identity, protected veteran status or disability.
EEO is The Law
Equal Opportunity Employer Minorities/Women/ProtectedVeterans/Disabled/Sexual Orientation/Gender Identity (http://www1.eeoc.gov/employers/upload/eeoc_self_print_poster.pdf)
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For accommodation requests, please call HR Services at 844-242-HR4U or visit HR Services Online at HRServices@highmarkhealth.org

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