Director Care Management (Natrona Heights)

Allegheny Health Network

Provides operational and strategic leadership for Hospital / facility Care Management Department. Collaborates with nursing and clinical leaders to assure smooth patient care progression and effective outcomes and care transitions. Directs collaborative efforts with physicians, revenue cycle and payor teams, and patients and their families to incorporate evidence based practices and appropriate use of resources. Communicates effectively with Hospital leadership in the development of day to day and strategic goals.

Essential Responsibilities :

• Evaluates effectiveness, leads improvement efforts, and assesses outcomes within Hospital to assure appropriate access, care progression, transition, and level of care determination practices.
• Studies and implements the care management model and structure to achieve sustainable length of stay, resource utilization, and clinical outcomes for patients over time. Responsible for designing and implementing improvement strategies for the care model on an ongoing basis.
• Directs and oversees all activity related to referral management. Leverages Epic and Careport / Allscripts data to assess effectiveness. Collaborates closely with Highmark Home and Community Services to establish and / or enhance post-acute network.
• Analyzes clinical service areas for operational effectiveness, using dashboards and other data sources. Monitors departmental performance against system initiatives and goals.
• Assures that department works collaboratively with patients, families, peers, and other departments in the organization / network to meet established organizational goals for patient experience.
• Pursues sharing of best practices through publication, presentation at conferences and networking with other AHN leaders throughout the system.
• Establishes a development plan for the department, with a focus on effective use of resources, inter-professional collaboration, and coordination with chronic disease, transitional planning, and specialty teams.
• Develops and implements workflows which assure efficient care coordination and transition, Hospital throughput, and adherence to payer requirements in order to minimize financial risk to patients and the health system.
• Lead and support evidence based projects & research by assisting in the identification of opportunities to incorporate the scientific method into practice.
• Other duties as assigned.

Qualifications :

Preferred : Master's Degree in Nursing, Health Administration, Leadership or related field

Disclaimer : The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job. Compliance Requirement : This job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies.

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