JOB SUMMARY: The primary responsibility of the Executive Director of Care Management (EDCM) is to provide management oversight to three or more hospitals in the counties noted below as well as assisting the VP of Care Management in the daily operations, implementation of the strategic plan and achievement of organizational goals across the 4 CPMC campuses. The Executive Director of Care Management is administratively responsible for the development of systems and day-to-day operations, continuity of case and clinical outcomes of all inpatient case management, including utilization review, discharge planning, social services, disease and population management and transitions of care programs. Sutter Health CPMC serves San Francisco and other bay Area hospitals with comprehensive health services.
REPORTING RELATIONSHIPS:
The Care Coordination Executive Director reports to the Sutter Health Bay Area VP Care Management. Reporting to this position are managers and the Care Coordination team at CPMC.
Qualifications JOB REQUIREMENTS: Education: - Masters in Nursing, Case Management, Health Administration, or Social Work is required; or equivalent education/experience.
- CA RN licensure required for nursing candidates and LCSW required for Social Work candidates.
- National Certification in Case Management (ACM, ANA RN-BC Case Management) within 18 months of hire date required.
Experience: 7-10 years experience as senior leader/manager in provider-based multi-site system or operational health plan management
Has managed key initiatives focused on Medicare affordability
Financially savvy leader who has assessed and developed utilization management functions
In-patient and out-patient experience for seamless integration
LEAN Management experience, ideally a Certified Workshop Leader
Leading department-level reorganization initiatives
Skills and Knowledge: Must be a knowledgeable about health care law, regulations, accreditation requirements and clinical standards of practice
Must understand business planning including analysis, statistics, budgeting, feasibility studies and implementation.
Knowledge regarding the health care market and government rules and regulations impacting potential health care reimbursement is required.
A thorough knowledge of capitation and all its implications as well as an understanding of other methods of health care financing is also required.
Understanding of and experience with Lean or other process improvement philosophies and methodologies desired.
Demonstrated ability to collaborate with nursing staff and medical staff to facilitate the transition of care for patients
Demonstrated ability to plan, set and accomplish multiple objectives.
Attention to detail, exhibit self-direction, high degree of independence, judgment and discretion, teaching ability, effective oral and written communication skills, demonstrate ability to work effectively with others as a team members and the leadership skills to implement and execute a region-wide utilization management.
Requires the ability to work with highly confidential and sensitive information.
Ability to plan, lead, organize, control and establish an esprit de corps in the area of responsibility.
Must have analytical and problem solving skills as well as the ability to coordinate and communicate effectively with diverse others including colleagues, nursing, managers, medical staff and be able to teach and develop others.
Must be able to prioritize, make decisions and set clear expectations for others.
Must possess excellent negotiation skills.
Savvy consensus-builder with proven experience building relationships
Understands mission driven, patient-centered care
Sophisticated leader who manages by influence
