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Director – Care Coordination (Remote Connecticut)

Director – Care Coordination (Remote Connecticut)

Job ID 
2017-4152
Job Locations 
US-Remote
US-CT-Hartford
US-FL-Tampa
US-Remote
Category 
Clinical/Utililization Management

More information about this job

Overview

The Care Coordination Program is a 90 day program following discharge from an acute or post-acute setting which includes a set of core program interventions that are directed toward the needs of members who are at risk for hospital readmission. A personalized care plan is developed based on patient assessments and a variety of clinical information obtained by the care team. The Care Coordination Program focuses on 6 pillars designed to promote a smooth transition to the home and prevent avoidable readmissions: Caregiver education. Medication reconciliation, Review of discharge instructions, Education on red flags, Follow-up physician appointments, Referrals to community resources

 

This position provides leadership and clinical operational oversight of the Post-Acute Care, Care coordination Program. Works alongside CareCentrix leadership teams for Product Development, Sales, Account and Clinical Management to establish and implement new programs and products to support CareCentrix position as an industry leader in post-acute care.

Responsibilities

  • Responsible for overseeing all day to day operational activities of the Post-Acute Care Program - Care coordination program to include: mentoring staff involved in member outreaches, providing performance feedback to the team’s management, team leadership and guidance regarding patient centered interventions, and promoting consistency in application of program standards.
  • Support and oversee clinical management team, clinicians and non-clinical associates within Post-Acute Care - Care Coordination Program
  • Participate in and/or lead various projects as identified by senior management to support operational efficiency, quality improvement, productivity enhancement, and revenue growth.
  • Provide support to the operations team members in clarifying responsibilities, guiding team members and building their skill set while ensuring effective team collaboration.
  • Assist and partner with the organization on the development and implementation of management reporting, key performance metrics, revenue forecasting, expense budgeting and associated periodic reporting.
  • Monitors performance and productivity of team and individual members and takes appropriate action to ensure guidelines and goals of the department are met. Completes performance evaluations and ensures Post-Acute Care – Care Coordination Program performance objectives are met.
  • Provide clinical expertise and project management methods in expansion of new/existing business opportunities across multiple states/clients. 
  • Work collaboratively with leadership teams of Account Management, Product Development, Sales and Medical Economics with business growth and expansion of clinical program initiatives
  • Clinical support to CareCentrix Product Development team in the strategic design and development of innovative clinical programs and systems. Act as a clinical business lead for HomeBridge and other new technology platforms to support CareCentrix business.
  • As needed, participates in sales presentations at the local, regional and national levels as required, maintaining CareCentrix as industry leader in the clinical management of home care services.
  • Participates in educating associates, management, customers, payers and physicians in best practices and protocols of care that drive both excellent clinical performance as well as optimizing financial results.
  • Participates in on-going quality assessment/improvement activities utilizing LEAN principals, as assigned. Ensures that information is documented/identified enabling the collection and root cause analysis of data to identify opportunities for improvement related to clinical programs. Oversees the development/ implementation of action plans that result in continuous quality improvement and sound clinical judgment
  • Interacts with health plan clinical partners, hospital staff, home health agencies and physicians to ensure effective education and communication of the tenets of Post-Acute Care Program.
  • Participates in special projects and performs other duties as assigned.
  • Must perform other duties as required or assigned.
  • 25% travel required

Qualifications

• Bachelor’s degree in nursing required.
• Current unrestricted /RN licensure along with a thorough and diverse knowledge of healthcare delivery, managed care regulations, utilization management, case management, and governmental home health agency regulations.
• A minimum of six to eight years’ experience in clinical operations and management of people.
• Experience in business and product development, preferred.
• Knowledge of State and Federal regulations in regard to Utilization Management and accreditation standards i.e. URAC, NCQA. Position requires strong writing, organizational, and communication skills, as well as strong business acumen.
• Due to the unique nature of the Post-Acute Care interventions, this position must be able to incorporate aspects of CM/DM into the patient self-management coaching model without building a traditional telephonic CM/DM department.

 

CareCentrix maintains a drug-free workplace in accordance with Florida’s Drug Free Workplace Law.