Director of Comprehensive Care

JOB SUMMARY Director Comprehensive Care Management (CCM) is responsible for planning, developing, and implementing the comprehensive care function of Baylor Scott and White Health (BSWH), which may include case management, social services, coordination of patient care, patient access, utilization management, and discharge planning.
Directs the management and analysis of case management and comprehensive care of patients to improve transition of clinical care for BSWH.
Develops and implements comprehensive care programs, policies, procedures, and initiatives that enhance cost effectiveness while providing quality care.
Recommends treatments and care that balance clinical and financial concerns with the family's needs and the patient's quality of life.
Monitors patient care activities that impact the coordination of effective comprehensive care delivery as well as the financial effectiveness of care.
Ensures that high quality patient care is delivered in a manner that meets the needs of patients, their families, physicians, the hospital, and BSWH.
Develops guidelines for working with insurers, managed care organizations, referral providers, patients, and families.
Monitors operations to ensure compliance with all applicable regulations and in accordance with BSWH policies, procedures, and performance standards.
An entity Director translates and implements strategic plans and objectives for area of responsibility.
Makes final decisions on operational matters and ensures achievement of objectives.
Recommends policies and organizational changes for area.
Plans and executes projects and initiatives that meet annual objectives.
Plans and directs the operations of a department or area, with responsibility for staffing, processes, budgets, and costs of the unit.
Leads and advises subordinate(s) to meet schedules, resolve technical problems, and monitor performance.
Has a larger, more complex organization or functional area than a manager.
Often has one or more managers or supervisors reporting to the role.
ESSENTIAL FUNCTIONS OF THE ROLE 1.
Directs CCM services for assigned area of responsibility for BSWH.
2.
Recommends and implements strategic and operational plans and priorities for CCM programs aligned to BSWH overall business objectives.
3.
Directs an interdisciplinary, integrated model of comprehensive care and discharge planning process with licensed professionals (RNs and social workers) who work within their scope of practice, clinical expertise, and license restrictions, and the para-professional staff (case management assistants and discharge advocates) who support the professional staff.
4.
Directs CCM services that include discharge planning, care coordination, and social work that advocate for the patient and family and ensure that services are delivered to meet the needs of patients and families.
5.
Develops and implements CCM programs and initiatives to ensure effectiveness of patient care and appropriateness of services.
6.
Leads the development and focus on census management, patient care outcomes, and other key care indicators.
7.
Identifies and resolves CCM service problems and inpatient care situations that arise.
8.
Implements and monitors CCM practice policies, procedures, and processes that comply with all applicable legal and regulatory requirements impacting CCM programs.
9.
Collaborates with cross-functional teams and hospital operations to identify opportunities for improvement, facilitate process changes, and lead action plans and follow up.
10.
Leads continuous improvement initiatives and Lean activities for CCM processes and service delivery.
KEY SUCCESS FACTORS 1.
Bachelor’s degree in nursing, social work, or related field preferred.
Master’s degree preferred.
2.
3+ years of experience in case management, social work, utilization review, or related field.
3.
Experience in a leadership role preferred.
4.
Registered Nurse (RN) or Licensed Clinical Social Worker (LCSW) required.
5.
Licensed Master Social Worker (LMSW) preferred.
6.
Knowledge of case management, discharge planning, transition of care, transfer coordination.
7.
Excellent verbal, written, interpersonal, and presentation skills.
8.
Ability to lead and influence multi-disciplinary teams in the delivery of a comprehensive care program.
BENEFITS Our competitive benefits package includes the following - Immediate eligibility for health and welfare benefits - 401(k) savings plan with dollar-for-dollar match up to 5% - Tuition Reimbursement - PTO accrual beginning Day 1 Note: Benefits may vary based upon position type and/or level QUALIFICATIONS - EDUCATION - Bachelor's or 4 years of work experience above the minimum qualification - EXPERIENCE - 3 Years of Experience - CERTIFICATION/LICENSE/REGISTRATION - Lic Clinical Social Worker (LCSW), Lic Masters Social Worker (LMSW), Registered Nurse (RN): Must be either a Licensed Masters Social Worker, Licensed Clinical Social Worker, or a Registered Nurse.