Director, Case Management

Health Quest - Poughkeepsie, NY3.6

Full-timeEstimated: $110,000 - $140,000 a year
EducationSkills
Overview
Health Quest was formed through an affiliation of four hospitals: Northern Dutchess Hospital (Rhinebeck, NY), Putnam Hospital Center (Carmel, NY), Sharon Hospital (Sharon, CT) and Vassar Brothers Medical Center (Poughkeepsie, NY). Health Quest also includes affiliated healthcare providers Health Quest Medical Practice and The Heart Center. Together, these hospitals and healthcare providers have devoted themselves to the development of clinical specialties and medical programs and services.

We also count among our partners long-term care facilities, a free-standing radiation oncology center, urgent care centers, a multi-specialty medical practice and a home care service.

HEALTH QUEST IS AN EQUAL OPPORTUNITY EMPLOYER.

Responsibilities
The Director, Case Management ensures that department services are integrated with other departments and functions within the Medical Center. The Director develops, implements and evaluates the operations plan for case management and ensures compliance with all CMS and other Federal and State regulations pertaining to the discharge planning process. The Director of Case Management is also responsible for leading departmental efforts around key strategic initiatives outlined below, including reducing length of stay and 30-day readmissions. Population served based on scope of services in the department.

Span of Control: Oversight of discharge planning, length of stay, readmissions and the Case Management Staff.

Essential Responsibilities:
1. Responsible for personnel management to include; interviewing and selection of staff, onboarding and training, counseling and disciplinary actions up to and including termination. Completes annual assessments and provides professional coaching and career path guidance.

2. Oversee day-to-day operations within span of control, resolving problems as necessary, and ensuring that operations are efficient, compliant, safe, and of the highest possible quality. Optimize management structures and workflows within span of control to continually improve quality and efficiency.

3. Identifies complex cases with high length of stay and leads weekly case reviews with members of the interdisciplinary team to assess and develop discharge resolutions for these patients and achieve quality measures around length of stay reduction.

4. Develops synergy, collaboration and formalization of processes between Case Managers and Community Care Managers to identify patients at high risk for readmission and ensure engagement of Community Care Managers to develop post-discharge plan.

5. Researches and promotes adaptation of industry best practices to ensure quality outcomes throughout the continuum of care including coordination of care, discharge planning, transition of care, and community care management.

6. Optimize financial performance within span of control. Review financial performance of all departments. Identify trends, variances, and opportunities. Act promptly to address problems and exploit opportunities. Participate in budget development by providing analysis, projections, and budget recommendations.

7. Develops and revises policies and procedures as they relate to the Case Management Department in collaboration with system for policy and procedure development.

8. Leads Case Management Crisis Response Team in conjunction with Manager of Social Work.

9. Ensures elements of Readmission Reduction Process Improvement program are implemented according to plan and provides ongoing supervision.

10. Complies with and enforces all Health Quest and affiliate policies and ensure compliance with all applicable law and regulation.

11. Maintain contemporary professional knowledge and education.

12. Demonstrates regular, reliable and predictable attendance.

13. Performs other duties as required.

Leadership Skill Requirements:
  • Maintain and Model REACH Values: (Respect, Excellence, Accountability, Compassion, Honor) .
  • Action and Results-Oriented: Ability to establish key goals, drive and track results among multiple decision-makers and stakeholders and meet deadlines in a fast-moving environment.
  • Political Savvy and Diplomacy:
o Ability to maneuver through complex, politically-charged situations and understand the dynamics and culture of the organization.
o Ability to anticipate problems and negotiate solutions with peers and senior leadership and other key stakeholders.

  • Ability to Build Relationships Through Integrity and Trust:
o Ability to quickly gain the trust and respect of others, drive collaboration, build a teamwork environment, search for the win/win scenarios.

  • Influencing Skills: Ability to lead an organization using influence, rather than possessing direct authority of others, being sensitive, yet direct in both verbal and written communications.
  • Managing Complexity: Ability to lead and drive results in a complex organization, achieving alignment between often conflicting priorities, initiatives and people.
Functional/Technical Skills Requirements:
  • Health Care and HIT Expertise: Comprehensive understanding of operational health care delivery systems and the current health care landscape. Skills and experience with developing competitive business strategies for health care. Skills and experience with the operational aspects of health care technology deployment. Familiarity and comfort with technology-based operational improvement. Health care management or consulting experience preferred.
  • Analytics and Strategy: Expertise in developing and executing data-driven approaches to enhancing business decision-making and improving operational performance (preferably in healthcare). Advanced knowledge of business intelligence best practices, familiarity with fact-based management tools and techniques to drive strategies and a continuous improvement culture.
  • Communications: Excellent written and verbal communications skills. Ability to take abstract, complex and/or technical information and break it down for a variety of audiences in a way that is meaningful for them.
  • Functional Oversight: Issue identification, gap analysis, ability to prioritize business needs and execute solutions.
  • Financial Management: Ability to understand financial reports, develop basic financial models, and identify trends, variances, and opportunities.
Qualifications

License, Registration, or Certification Requirements:
  • Current NYS Register Nurse (RN) license.
  • PREFER: Certification in Case Management.
Education and Experience Requirements:
  • Bachelor’s Degree in Nursing (BSN).
  • Minimum of three to five (3- 5) years’ experience in Acute Care Nursing.
  • Minimum of one year experience as a Case Manager in an Acute Care setting.
  • Minimum of three (3) years Supervisory experience in utilization management, case management, discharge planning or comparable professional area.
  • PREFER: Master’s Degree in Nursing (MSN) or related field.
  • PREFER: Advanced clinical standing as Nurse Practitioner.
Minimum Knowledge, Skills and Abilities Requirements:
  • Must be able to manage multiple competing priorities and maintain calm demeanor in stressful environment.
  • Proficiency with computers and clinical applications.
  • Ability to effectively negotiate with patients, families, internal and external providers of patient care services.