St Luke's University Health Network Allentown , PA 18101
St. Luke's is proud of the skills, experience and compassion of its employees. The employees of St. Luke's are our most valuable asset! Individually and together, our employees are dedicated to satisfying the mission of our organization which is an unwavering commitment to excellence as we care for the sick and injured; educate physicians, nurses and other health care providers; and improve access to care in the communities we serve, regardless of a patient's ability to pay for health care.The Director coordinates and supervises the operations of the Care Management Department. The Director is responsible for establishing, implementing and maintaining the components of the Care Management process that are focused on the achievement of satisfactory patient outcomes with specific timeframes through the appropriate utilization of available internal as well as external resources. The Director is responsible for providing oversight of discharge planning, transitions of care, and support of utilization management as directed by the policies and procedures of the hospital
JOB DUTIES AND RESPONSIBILITIES:
Participates in the development and execution of the department strategic plan to assure goals and objectives are met.
Develops department budget and monitors monthly for variance reporting for assigned hospitals.
Assures that services are provided consistent with the requirements of regulatory agencies and under the Conditions of Participation. Responsible for the implementation of regulatory standards as they relate to Care Management and the continuum of care/discharge planning.
Collaborates with HR and other hiring partners to maintain an appropriate staffing complement that will ensure positive productivity outcomes.
Provides direct clinical and administrative direction to the Care Management department staff.
Conducts yearly performance evaluations of staff and assesses monthly audit findings in order to provide feedback and content toward performance improvement plans.
Provides educational training for Care Management personnel, clinical staff, and ancillary departments.
Completes monthly quality audits of direct care manager reports to support evaluation and adherence to workflow process, appropriate and accurate use of software, documentation, and training needs.
Serves as a liaison to the Finance Department related to value based reimbursement and contracts in order to support payer/vendor Care Management strategies.
Supports implementation of new software technology to support integrated Care Management.Provides Care Management leadership and representation at designated service line Performance Improvement meetings.
Assures leadership and representation of Care Management for community organizations post acute facilities, and external services for the assigned hospitals.
Monitors data including variance analysis, aggregate trend analysis and recommendations for changes in practice. Responsible for reporting to and participation in the Network Utilization Management Committee and the Network Care Management Committee for the assigned hospitals.
Develops monitors and maintains mechanisms to assure that the complex needs of patients and families are systematically identified, assessed and managed within appropriate time frames with optimum patient outcomes.
PHYSICAL AND SENSORY REQUIREMENTS:
Sitting for one to two hours at a time. Standing for up to 2 hours per day, up to 10 minutes at a time.
Walk on all surfaces for up to 3 hours per day, and climb stairs. Must be capable of driving a car. Fingering and handling objects frequently, uses fingers to turn pages.
Frequently uses hands to write and/or type. Rarely uses hands or fingers for firm grasping or twisting/turning. Frequently uses upper extremities to lift and carry object up to 10 lbs.
Rarely may be required to lift, carry, push, and/or pull objects weighing up to 75 pounds. Occasionally stoops, bends, squats, kneels and reaches above shoulder level. Must have the ability to hear as it relates to normal conversations and high and low frequencies and to see as it relates to general and peripheral vision. Must have the ability to touch as related to telephone and computer keyboard.
Graduate of accredited school of Nursing required. MSN Preferred; currently licensed as a Registered Nurse in the state of Pennsylvania or MSSW.
TRAINING AND EXPERIENCE:
5 years of Care Management experience in an acute care hospital setting, care management program or value-based care management model. Leadership experience preferred. Strong critical thinking skills. Ability to maintain collaborative and effective working relationships.
Please complete your application using your full legal name and current home address. Be sure to include employment history for the past seven (7) years, including your present employer.
Additionally, you are encouraged to upload a current resume, including all work history, education, and/or certifications and licenses, if applicable. It is highly recommended that you create a profile at the conclusion of submitting your first application. Thank you for your interest in St. Luke's!!
St. Luke's University Health Network is an Equal Opportunity Employer.