Director, Care Management - 127040

The Director, Care Management is responsible for the direct supervision of Care Managers and Clinical Social Workers at UC San Diego Health East Campus, as well as the development and implementation of site-specific Care Management activities that are consistent with organizational priorities and compliant with accreditation, regulatory and licensure requirements. The Director uses a data-driven approach to continuously improve departmental performance leading to high reliability and to plan and allocate resources. The Director builds strategic partnerships to improve care management and create safe and efficient transitions of care. The Director is responsible for leading best practice work as it relates to care management, continuity of care and clinical outcomes in the inpatient, emergency and psychiatric settings including utilization management, discharge planning, referrals, authorizations, and social work.

The Director promotes solutions that accelerate the dissemination of successful best practices in care management within the hospital, promotes patient centered care and creating organizational alignment around care management. Deliverables result in measurable improvements in quality, service and efficiency across the organization for the benefit of patients, caregivers and customers. The Director is a leader in the organization's pursuit of high reliability in a culture of safety, and plays a critical role in strategic initiatives as well.

Position involves the collaborative process among clinicians (typically social services, discharge planning, utilization review, patient throughput), that assesses, plans, implements, coordinates, monitors, and evaluates the options and services required to meet the patient's complex medical discharge planning and transitions of care needs, as well as the health and human service needs. Role is characterized by planning, advocacy, communication, and resource management and promotes quality and cost-effective interventions and outcomes. Directs resources, evaluates and implements new programs. Contributes to strategic plans and policies that have impact throughout the medical center and/or health system.

Key Responsibilities:

* Participates in the strategic planning of care coordination programs, workflows, policies and procedures across the medical center and/or health system.
* Oversees and directs the development of systems to support integrated, effective and efficient work processes.
* Collaborates with Information Technology senior management to integrate care coordination and case management needs in organization-wide IT initiatives, including electronic medical records, revenue management, patient finance, and business intelligence.
* Oversees data analysis and the preparation of presentations, proposals and executive summaries. Utilizes data and metrics to prioritize quality initiatives and long and short term strategic planning.
* Collaborates with patient care directors, service line directors, physician and executive leadership across the medical center or health system, to improve coordination and facilitate optimal patient care throughput. Approves and oversees the implementation of quality improvement measures and plans.
* Advises and consults with physician and executive leadership on integrating case management into patient care delivery models.
* Provides strategic direction to assist in ensuring compliance with accreditation and licensure requirements with the clinical services environment, including JCAHO, CMS, and State of California.
* Responsible for employee performance reviews, recruitment, retention, terminations, and staff development and training programs. Instills strong management practices to create a culture of teamwork, collaboration, and timely achievement of objectives and goals.
* Reviews, approves, and oversees the implementation of best practice methods and policies which improve both patient quality of care and the financial outcomes for the medical center.
* Other duties as assigned.

MINIMUM QUALIFICATIONS

• Bachelor's degree in nursing and eight or more years of relevant experience, or equivalent combination of experience, education and training.

• Registered Nurse licensed in the state of California.

• Experience and proven success in hospital management skills, with progressive expertise in case management, utilization review, discharge planning, home care and/or managed care.

• Three or more years of progressive leadership experience including oversight of care managers.

PREFERRED QUALIFICATIONS

• Advanced degree in nursing or relevant field of study.

• Current Case Management Certification.

• Five or more years of progressive leadership experience including oversight of care managers, ideally in an acute care setting.

• Case Management experience in a Psychiatric setting.

SPECIAL CONDITIONS

• Must pass a background check.
• Must pass a pre-employment physical, drug screen and immunization screening.
• Must be able to work various hours and locations based on business needs.

Pay Transparency Act

Annual Full Pay Range: $99,600 - $274,000 (will be prorated if the appointment percentage is less than 100%)

Hourly Equivalent: $47.70 - $131.23

Factors in determining the appropriate compensation for a role include experience, skills, knowledge, abilities, education, licensure and certifications, and other business and organizational needs. The Hiring Pay Scale referenced in the job posting is the budgeted salary or hourly range that the University reasonably expects to pay for this position. The Annual Full Pay Range may be broader than what the University anticipates to pay for this position, based on internal equity, budget, and collective bargaining agreements (when applicable).