Executive Director of Care Management

Job Summary

The Executive Director, Care Management oversees all of the assigned facility’s Social Work, Case Management and Utilization Management services in addition to related programs or initiatives that may be embedded within the institution’s care coordination/care management department. He/she develops and directs the administration of the care management model, working closely with the Executive Director, Care Management at the partner facility to standardize processes and procedures, share best practices, and present a unified approach to achieve desired outcomes.

Role Accountabilities Include:

Serves as a consultant to the VP of Medical Affairs in charting the strategic path for the Department

Develops and oversees capacity management processes to actively manage LOS and advance the progression of care of patients with significant barriers to discharge; uses experience and clinical judgement to identify solutions for escalated cases

Uses data to effectively lead re-engineering of service delivery processes to achieve high quality and efficient care and ensure accountability of team to meet Key Performance Indicators

Ensures that state and federal regulatory, accreditation and compliance standards are met

Develops and coordinates programs with community service organizations and works in partnership with departmental leaders to implement initiatives

Represents care and utilization management operations and interests in appropriate hospital, health system, trade association, regulatory and/or other meetings/committees/work groups

Qualifications:

• Master’s degree in Social Work, Nursing or related field
• Active licensure in Social Work, with clinical certification (LCSW-C) or Registered Nurse (RN); must be certified in Case Management if RN
• Minimum of 10+ years of progressively responsible social work or nursing administrative experience including 5-7 years of management experience with significant business impact, preferably within an academic medical center
• Must have a demonstrated record of accomplishment in health care administration or clinical practice, and innovative practice delivery
• 5 years in clinical health care setting, including direct experience in quality assessment, resource management and case management required