Assistant Vice President, Care Coordination

Assistant Vice President of Care Coordination and Post Acute

How would you like to work in a place where your contributions and ideas are valued? A place where you can serve with compassion, pursue excellence and honor every voice? At Wellstar, our mission is simple, yet powerful : to enhance the health and well-being of every person we serve. We are proud to have become a shining example of what's possible when the brightest professionals dedicate themselves to making a difference in the healthcare industry, and in people's lives.

Core Responsibilities and Essential Functions :

Executive Leadership : Provides executive leadership working with VP Clinical Outcomes as dyad partners, for the care coordination strategy, in collaboration with physician leadership and other key clinical partners, care coordination programs to improve the quality and affordability of our care. Serves as a key partner for the development of future programs for chronic disease management and complex care coordination. Responsible for implementation of the approved WellStar care coordination and transitions of care operating model. Emphasis on accelerating improvement and organizational transformation. Provides leadership for coordinated functions such as clinical authorizations and resolutions, telephonic support, coaching and training. Organizes key stakeholders including hospital, post-acute and medical group leaders to coordinate efforts and identify potential solutions and ownership of goals such as reducing length of stay, readmissions, discharge appointments and improving transitions of care. Leads and directs the efforts to develop standard work for case management, utilization management, social work, etc. Partners with System leadership for goal setting, periodic review of performance and strategic consulting. Partners with System leadership to develop best clinical practices : such as reduce length of stay, reduce variation and reduce readmissions. Ensures consistency and accountability for coaching and training aspect of transition of care model. Supports collaboration within care management function to ensure seamless interfaces across the care continuum. Identifies opportunities to improve the patient service and quality outcomes for our patients, physicians and other caregivers. Collaborates with system-level executives to initiate innovative healthcare pilots to improve the overall care management function. Oversees the development of clinical management guidelines including proactively identifying evidenced-based best-in-practice approaches and changes in practice which may require updating of guidelines. Develops and implements feedback loop with all care entities related to care management operating model, including physician education and consultation to ensure accuracy of clinical documentation. Partners with the VP Health Information Management and Coding Compliance to ensure and improve data accuracy. Leads, supports and participates in quality initiatives and activities that are impacted by or benefit from care coordination and transitions of care. Partners with the regional delivery system to implement healthcare management, utilization, cost and quality objectives in accordance with WellStars mission, vision and credo, the needs of customers and applicable federal and state regulatory requirements. Maintains knowledge of local and national trends in healthcare delivery and changes in legislation and accreditation standards that affect the organization as well as developments in case management as it applies to care transition, payment methodologies, utilization management, discharge planning, social services and contracting. Oversees the dissemination of innovations and best practices in these areas to key entities throughout WellStar.

General Management : Leads the definition and implementation of the change management strategy including : the future state care management staffing, based upon leading best practices. Oversees the development and implementation of processes, workflows and tools to support the following for the continuum of care : initial and concurrent clinical review, target LOS and discharge disposition, patient flow, medical referrals, discharge planning / referrals to post acute or palliative care, discharge assessments, transitions of care (e.g., post discharge calls, follow-up appointments, etc.), care facilitation and escalation process, outlier management and observation patients, concurrent clinical denial management and payer communications. Ensures consistency in focus of among key stakeholders so that system, regional, initiative and departmental goals are met. Oversees development of improvement plans, goals, implementation strategies and outcome measures. Ensures implementation of approved care coordination and transitions of care operating model is aligned, coordinated, organized and timely. Facilitates affinity groups, work teams, task forces and clinical implementation teams at both system and operational levels. Seeks and incorporates input from WellStar physicians, WellStar Clinical Partners, affiliates to be sure relevant stakeholder perspectives are included in development and implementation. Oversees the development and implementation of the coaching / training model. Ensures compliance with state reporting on utilization management activities for accuracy. Develops the annual operating and capital budgets to sufficiently meet departmental needs.

Resources and Support : Partner with Information Technology team to lead and provide technical resources for : the design, development, acceptance, and implementation of care and disease management pathways, standardized practices and performance standards, clinical conditions and related procedures the design, development, acceptance, and implementation of Emergency Care and Hospital Admission / Discharge / Inpatient Care Protocols that coordinate closely with complementary WellStar primary / specialty care practice protocols Advocate for an accessible and compatible clinical information and informatics functionality to support optimal care management Leads efforts to develop reports and key performance indicators for each region, initially for each hospital. Oversees the development and implementation of ongoing variance management oversight and monitoring of the key performance indicators including real-time monitoring, gap analysis, variance mitigation strategies and ongoing training and processes updates. Leads the development of real-time actionable decision support reports and other tools to enable the coordination of care that meets the triple aim. Reduce unnecessary waste, variability, duplication, and / or customization in the use of supplies, medication, and human resources Support medical group, hospitalists and health system efforts to reduce unnecessary variation and inefficiency in clinical practice and communications within hospital-based care Develops appropriate care management dashboards, reports, and alerts Articulates federal and state payment systems and regulations, as well as private insurance issues in partnership with Compliance, Health Information Management and Coding. Analyzes marketing opportunities, developing strategies to communicate and advance the Hospital and serves and works with public relations and community boards to do the same. Support advancement of the image of the Hospital and Nursing in the community.

Program Credibility : As an executive leader of a critical function, works closely with WellStar System, WCP, Hospital, Post-Acute, Medical Group and affiliate leadership. Ensures pertinent updates to appropriate WellStar audiences to maintain consistent communication regarding the results achieved by function. Serves as a balanced advocate of system, hospital, post-acute and affiliate perspectives to ensure success of goals. Establishes trusted partner relationships with key stakeholders. Solicits involvement of expert managerial and physician champions, other clinicians, and additional resources as needed. Leads or actively supports and participates in relevant affinity groups, teams, committees and other groups as needed based on the planned objectives. Proactively addresses concerns in a forthright and professional manner. Acts as a leader to align teams and business partners in transformational efforts to ensure performance goals are met across the System in an efficient manner. Overcomes barriers and challenges using negotiation and diplomacy Performs other duties as assigned Complies with all Wellstar Health System policies, standards of work, and code of conduct.

Required Minimum Education :

Bachelor's Degree Required and Master's Degree from accredited schools Required and Degree in a clinical discipline is strongly Preferred

Required Minimum License(s) and Certification(s) :

All certifications are required upon hire unless otherwise stated.

Additional License(s) and Certification(s) :

Required Minimum Experience :

Minimum 10 years of healthcare experience in a hospital health system required Required and Minimum 10 years of progressive leadership experience in a large tertiary hospital or complex health system Required and Minimum 10 years of care coordination experience Required and Substantial working familiarity with inpatient care and processes and a deep working understanding of the functions of a large tertiary medical center or health care system well known for its effectiveness in care integration. Required and Demonstrated progression in management / leadership experience in a large hospital or health system Required and Experience in a multi-hospital system environment is strongly Preferred and Experience in multiple markets is highly desirable. Experience with accountability for the design and effectiveness of care improvement, care processes, and / or transitions in care. Experience with LEAN methodologies Preferred

Required Minimum Skills :

Display a working knowledge of contemporary medical informatics, clinical decision support systems, and electronic medical records (EPIC preferred); Should possess excellent verbal and written communication skills and relationship building; commitment to patient care excellence in healthcare and has a proven track record of success; strong interpersonal and leadership capabilities; sound performance management skills and experience with an emphasis on change and the ability to develop consensus from independent parties to achieve the goals of the health system; evidence of strong physician and executive collaborative initiatives required; Be comfortable and effective navigating a matrixed environment ; experienced in the design and implementation of large scale, local process, and quality improvement, including exposure to LEAN principles, and other redesign and improvement methodologies; knowledge of strategic and financial planning and management; experience in working with the system-wide direction of patient care activities; commitment to the advancement of nursing practice and the nursing profession; high degree of initiative, is self-directed and independent, and welcomes ideas and input of others; adept at follow-through; knowledge of risk management and various accreditation / regulations / licensing requirements assuring that these are upheld while advancing industry standards through the achievement of goals by effective management and measurement of outcomes. This professional should be active in the profession, member of a professional organization and attends state and national conferences to keep up with advances.

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