Director, Complex Care Solutions

Location
Norfolk, VA
Salary
Competitive
Posted
Aug 19, 2019
Closes
Aug 27, 2019
Ref
125793BR
Function
Management
Industry
Healthcare
Hours
Full Time
Serves in a dyad partnership with clinical leaders to develop, implement, operate, and evaluate clinical care models that improve health, quality, safety, and utilization by SMG complex care patients, especially patients in value-based care programs. Supervises Integrated Care Management staff and provides strategic planning and leadership to support quality and safety, care transitions, utilization management, and proper coding among Integrated Care Managers. Design and implement models to improve adherence in complex care patients, and improve HCC Coding performance among complex care patients. In partnership with IT, Analytics, and other clinical leaders, develops definitions, tools, and analytics to identify complex care patients according to disease, social, behavioral, and functional status, track interventions, assess performance, and identify service needs. Maximizes teamwork and collaboration with other members of the SMG Population Health Leadership Team, including SMG Pharmacy, RN Centralized Clinical services, APC Senior Health Services, Coding/documentation services, Hospital Medicine, Analytics and IT. Aligns department work with system goals, CMS/State/DNV requirements, Standards for Care Transitions and American Case Management Association.

Qualifications

Education Level
Bachelor's Level Degree

Experience
Required: Case Management - 3 years, Leadership - 3 years, Population Management - 3 years, Utilization Management - 3 years

Preferred: None, unless noted in the "Other" section below

License
None, unless noted in the "Other" section below

Skills
Required:

Preferred: None, unless noted in the "Other" section below

Other
Bachelors in Nursing, Business, or Healthcare Administration required. Masters Level Degree (MSN, MBA, MHA) preferred or required within 2 years of employment

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