AdventHealth Director Care Management System FT Days in Maitland, Florida
Director Care Management System AdventHealth Maitland FT
Location Address: 915 Winderly Road
Top Reasons to work at AdventHealth
- Faith based & mission driven organization
- CREATION Health employee wellness and lifestyle programs
- Positive working climate to support a work life balance
• Full Time - Days
You Will Be Responsible For:
- Serves as a change agent to re-structure or improve hospital clinical or operational monitoring activities to reflect the philosophy of the evidence based medicine/disease management/clinical programs initiatives.
- Assumes implementation responsibilities for change activities required to re-engineer hospital clinical processes to address resource consumption issues.
- Educates Medical Staff and hospital administrative staff concerning current trends in cost/resource management.
- Identifies clinical topics for review and analysis by medical staff monitoring committees, based on consistent monitoring of clinical practice patterns, feedback from clinicians and physicians and retrospective data analyses of quality, resource consumption and cost reports at a DRG and physician-specific level.
- Develops an active, collaborative, interface and structure with AdventHealth Medical Staff
What Will You Need:
EDUCATION REQUIRED :
- Bachelor’s degree in Nursing
- Master’s degree in Nursing, Business, or health-related field
EXPERIENCE REQUIRED :
- Seven to ten years’ acute care hospital clinical experience
- Five years’ progressively responsible leadership experience
- Previous case management, utilization management, or related discipline experience
LICENSURE, CERTIFICATION, OR REGISTRATION REQUIRED :
- Current, valid State of Florida license as a registered professional nurse
LICENSURE, CERTIFICATION, OR REGISTRAITON Preferred:
- Nursing specialty certification
- Case management certification: Accredited Case Manager (ACM), Certified Case Manager (CCM), Board Certified in Case Management (RN-BS)
Under minimal supervision, the Director – Care Management - System develops and coordinates implementation of complex hospital strategies, involving physicians and multiple hospital departments, to assure appropriate utilization of hospital resources, appropriate level of care for patients, and appropriate discharge planning. Responsible for assuring appropriateness of patient admissions based on severity of illness/intensity of service criteria. Facilitates case reviews based on medical screening criteria and oversees denial management process to third party payers to ensure optimum reimbursement. Responsible for case management, utilization review and social worker/discharge planning processes for AdventHealth business units. Responsible for building and maintaining positive working relationships with medical staff, external agencies (ECF’s, sub-acute facilities, Home Care) and all members of the health care team. Responsible for on-going operations, short- term and long-term planning and development of the outcomes management service area for AdventHealth. Develops and implements state-of-the-art performance improvement and outcomes management programs that enhance the operational, financial, and clinical performance of the organization. Implements and oversees the maintenance and use of databases and systems for measuring, monitoring, and tracking utilization and performance changes. Leads and directs cross-functional teams for achieve results. Works closely with physicians and the campus leadership team on utilization/case management issues. Actively participates in outstanding customer service and accepts responsibility in maintaining relationships that are equally respectful to all.
This facility is an equal opportunity employer and complies with federal, state and local anti-discrimination laws, regulations and ordinances.
Category: Case Management
Organization: AdventHealth Orlando
Shift: 1 - Day
Travel: Yes, 50 % of the Time
We are an equal opportunity employer and do not tolerate discrimination based on race, color, creed, religion, national origin, sex, marital status, age or disability/handicap with respect to recruitment, selection, placement, promotion, wages, benefits and other terms and conditions of employment.