Director of Care Management
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Job Location:
Langhorne, PA - USA
Monthly Salary:
Not Disclosed
Posted on:
2 days ago
Vacancies:
1 Vacancy
Job Summary
Employment Type:
Full timeShift:
Day ShiftDescription:
Job Title: Director of Care Management
Employment Type:Full-time
Shift:Day Shift Monday - Friday
Location: St. Mary Medical Center - Langhorne PA
Nazareth Hospital - Philadelphia PA
Position Purpose:
The Director of Care Management will direct the department in a collaborative model focused on patient-centered care and thedeliberate organization of servicesacross the continuum. This role bridges the acute setting and community transition by establishing formal partnerships and ensuringseamless information sharingamong multidisciplinary teams toeliminate barriers to discharge. The goal is to facilitate communication and resource coordination through advocacy education andcomprehensive assessment of social determinants while managing transitions and disease management programs. Responsibilities include the oversight of compliance standards and clinical outcomesspecifically targetingreduced fragmentation in careandoptimized length of stayto improve readmission rates capacity management and financial indicators.
What You Will Do:
Directs the overall care management program including case management social work and utilization review.
This involves setting departmental goals establishing policies and managing budgets.
Maintains collaborative relationship with Medical Staff and facilitates education on documentation government regulations and payer contracting matters
Oversees processes to ensure patients are at the correct level of care (e.g. observation vs. inpatient) and that hospital resources are used efficiently.
Lead the Utilization Management Committee to report on denial trends and resource consumption
Assures hospital adherence to all Federal State and Local regulatory and compliance guidelines related to utilization
Oversight of critical processes related to compliance of both medical necessity and appropriate level of care; coordinates utilization review processes to assure adherence to regulations
Supports the Utilization Management and Appeals Supervisor and the Manager of Care Management to assure the functions of care coordination in the acute setting meet the goals of resource consumption capacity management and patient centered care
Develops programs to support length of stay initiatives to manage capacity and assure the right care at the right time
Assures hospital adherence to all regulatory guidelines related to discharge planning
Continuously seeks best practice approaches to assuring patients are discharge ready including coordination of services coaching and transition of information
Minimum Qualifications:
Master of Science in Nursing (MSN) degree from an accredited school of nursing required.
Current Registered Nurse license by Pennsylvania Board of Nursing or Compact State.
At least 3-5 years leadership experience in case management
CCM (Certified Case Manger) or ACM (Accredited Case Manager) preferred
Position Highlights and Benefits:
Comprehensive benefit packages including medical dental vision mental health paid time off 403B educationassistanceand voluntary benefits (pet insurance accident insurance hospitalindemnityand others) available fromthefirstday of employment.
Work/Life balance with flexible schedules.
Free onsite parking.
Our mission and core values are what drive each member of Trinity Health to support each other communicate openly and respectfully while embracing a culture that nurtures a healing safe environment for all.
Referral Rewards Program
About us:
St. Mary Medical Centeris a beautiful 53-acrestate-of-the-artfacilitycomprisedof more than 700 physiciansnearly 3000colleagues and 1100 volunteers committed to providing quality care delivered with compassion and . Mary attracts top doctors introducescutting-edgetechnologiesand implements advanced procedures to meet the healthcare needs of the people it serves including thenearly630000residentsof Bucks County.
Nazareth Hospitalserves Northeast Philadelphia and the surrounding region. With over 160 inpatient beds and many outpatient services Nazareth Hospital has a broad range of specialties to meet patients health care Hospital offers outstanding diagnostic medicalsurgicaland therapeutic care withstate-of-the-arttechnology. With the dedication of 1200 employees and 350 physicians and specialists Nazareth Hospital treats patients and their families with respect and compassion while providing health care services in response to the changing needs of our community.
Our Commitment
Rooted in our Mission and Core Values we honor the dignity of every person and recognize the unique perspectives experiences and talents each colleague brings. By finding common ground and embracing our differences we grow stronger together and deliver more compassionate person-centered care. We are an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race color religion sex sexual orientation gender identity national origin disability veteran status or any other status protected by federal state or local law.
Required Experience:
Director
Key Skills
About Company
Trinity Health is one of the largest not-for-profit, Catholic health care systems in the nation. It is a family of 115,000 colleagues and nearly 26,000 physicians and clinicians caring for diverse communities across 25 states. Nationally recognized for care and experience, the Trinity ... View more
