Division Director Care Coordination
Company: Common Spirit
Location: Rancho Cordova
Posted on: June 20, 2022
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Job Description:
Overview
Two legacies of caring.
One ministry of change.
CommonSpirit was created by the alignment of Catholic Health
Initiatives and Dignity Health as a single ministry in early 2019.
More than 150,000 physicians, nurses, caregivers, and other staff
are employed by CommonSpirit Our hospitals and care centers cover
21 states. CommonSpirit has the size and ability to scale
best-in-class clinical service lines; recruit and retain top
talent; standardize operations to improve quality and reduce the
cost of care; and advocate more effectively for all people,
especially those who are poor and vulnerable. For more information,
please visit our website at www.commonspirithealth.org. You can
also follow us on Twitter and Facebook.
Responsibilities
Job Summary / Purpose
* The Division Director, Acute Care Coordination is responsible for
providing leadership in the development, implementation, and
oversight of a care coordination model which will support a
patient-centered care delivery model across the assigned division.
This position is responsible for the development and implementation
of standards, systems, policies, and procedures in alignment with
organizational strategic initiatives and that is focused on quality
and financial outcomes. Specifically, this position leads division
wide efforts to optimize care coordination across the care
continuum. This coordination ensures a plan of care for patients in
all stages of health needs. The plan of care process will also
ensure efficient resource utilization, quality outcomes, and
maximize reimbursement.
Essential Key Job Responsibilities
* Oversees and/or directs the development, implementation and
standardization of division-wide care coordination, utilization
management, and social work services policies, procedures and
programs in conjunction with related goals and objectives. Ensures
compliance with federal and state regulations, as well as
established organizational policies and procedures.
* Establishes and oversees the development and implementation of
programs, short and long-range goals and objectives and determines
the optimal progression to obtain these goals. Reviews analyses and
reports of various activities to determine department progress
toward stated goals and objectives.
* Provides oversight for the medical necessity reviews, denials
management, utilization management supporting all areas of the
organization within the assigned division. This includes strategy
development which will improve reimbursements and reduce denials as
related to federal, state and commercial programs in partnership
with Common Spirit Health Partners.
* Ability to develop strong partnerships with clinical partners and
clinical integration activities in order to optimize care
coordination across the care continuum. Ensure efficient resource
utilization, improve quality outcomes and enhance patient
satisfaction.
* Maintains effective communication and a strong leadership
presence with executive partners, senior leaders, internal and
external customers to coordinate and adequately address patient
care needs.
* Reviews, prepares, analyzes, and presents reports and
recommendations to senior management regarding operations and/or
other applicable areas of interest in order to provide concise and
accurate information that aids in decision-making. Develops,
reviews, and monitors clinical, service and financial outcomes
using performance metrics.
Qualifications
Required Education and Experience
* Master's degree or equivalent education / experience in nursing
or healthcare/business related field.
* Minimum of 5 years of experience in healthcare managerial
position.
Required Licensure and Certifications
* Current Registered Nurse (R.N.) license.
Required Minimum Knowledge, Skills, Abilities and Training
* Extensive understanding of case management practices and
knowledge of reimbursement methodologies
* Effective leadership, human relations and communications
skills
* Ability to identify and address customer needs in a team
environment
* Ability to effectively engage physicians, payers, management
level staff, employees, and stakeholders in order to build
partnerships, achieve strategic initiatives, and attain
organizational goals.
* Ability to manage problems and situations where uncertainty is
inherent constructing new and innovative solutions for complex and
varying problems and situations while approaching issues/problems
by considering the larger perspective or context
* Analytical and conceptual system-thinking and the ability to
manage multiple projects.
Keywords: Common Spirit, Rancho Cordova , Division Director Care Coordination, Executive , Rancho Cordova, California
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