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Director, Case Management

Company: East Orange General Hospital - 300 Central Avenue
Location: East Orange
Posted on: February 14, 2021

Job Description:

Director, Case ManagementJob SummaryEast Orange General Hospital has been a trusted heath resource for generations of families in the Newark area. Our acquisition by Prospect Medical Systems in 2016 has brought with it millions dollars in capital to stabilize our finances, invest in new programs and technologies and leverage a wide array of health management techniques that improve both quality and efficiency. We are looking for an enthusiastic, experienced and entrepreneurial Director of Case Management to join our team. The ideal director candidate will provide operational and strategic leadership for East Orange General Hospital Care Management Department. Collaborates with nursing and clinical leaders to assure smooth patient care progression and effective outcomes and care transitions. Directs collaborative efforts with physicians, revenue cycle and payor teams, and patients and their families to incorporate evidence-based practices and appropriate use of resources. Communicates effectively with Hospital leadership in the development of day to day and strategic goals.
Essential Functions

  • Establishes systems to facilitate entry of patients into appropriate bed, unit, and level of care. Evaluates effectiveness and leads improvement efforts within Hospital to assure appropriate access and level of care assignment.
  • Develops and implements strategies with internal and external providers to ensure placement of patients in the right level of care at the right time, predictably. Participates in collaborative forums to assure consistent practice.
  • Studies and implements the care management model and structure to achieve sustainable length of stay, resource utilization, and clinical outcomes for patients over time. Responsible for designing and implementing improvement strategies for the care model on an ongoing basis.
  • Establishes a development plan for the department, with a focus on effective use of resources, inter-professional collaboration, and coordination with chronic disease, transitional planning, and specialty teams.
  • Directs and oversees all activity related to referral management. Leverages Allscripts data to assess effectiveness. Collaborates closely with Community Services to establish and/or enhance post-acute network partnerships.
  • Strong knowledge of regulatory standards for federal payers, TJC, and other insurance companies.
  • Creates an environment that embraces cultural diversity and recognition that we are stronger as an interdisciplinary team when we embrace our differences.
  • Promotes an environment of transparency with employees and nursing department.
  • Actively participates in review and identification of opportunities of nurse quality indicators as measured by NDNQI at individual department level collaborating with nurse managers.
  • Benchmarks EOGH performance against national best practices.
  • Pursues sharing of best practices through publication, presentation at conferences and networking with other leaders throughout the Prospect system.
  • Performs large-scale project management independently.
  • Implements and monitors initiatives to recognize, reward and incentivize staff.
  • Actively participates in the development and communication of nursing's shared vision.
  • Seeks out learning opportunities to enhance professional growth and development. Creates and updates personal professional development plan annually. Minimally meets state requirements for continuing education.
  • Identifies opportunities for journal publications for self and staff.
  • Participates in a research project.
  • Lead and support evidence-based projects & nursing research by assisting in the identification of opportunities to incorporate the scientific method into nursing practice.
  • Financial stewardship: monitors, controls, and is accountable for maintaining departmental costs within budgeted allocations.
  • Builds trusting and collaborates relationships with other hospital departments, patient care units, ambulance services, medical staff, patient and families, law enforcement officers, clergy, morticians, media and other health facilities.
  • Utilizes a transformational leadership style to facilitate effective change management principles to drive needed improvements.
  • Reviews patient satisfaction data and findings from Press Ganey/ HealthStream and assists in coaching managers formulate improvement plan.
  • Analyzes clinical service areas for operational effectiveness, using dashboards and other data sources.
  • Oversees and ensures that standards of care are maintained relative to quality management, utilization review, and discharge planning.
  • Accountable to ensure ongoing development and operation of Shared Governance model in all departments.
  • Serves as a consultant for nurse managers and medical staff on patient care or nursing issues assisting with interpretation of Health Center policies to ensure patient needs are met.
  • Through research and planning ensures patient care is delivered in accordance with the professional standards for nursing practice and is evidenced based.
  • 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.
    Other DutiesPlease note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities and activities may change at any time with or without notice.Minimum Education/Certifications -- NJ State Registered Nurse License-- BSN degree or equivalent education and years of experience-- National Certification required within 1 year of taking position-- 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.-- If Social Worker, then LCSW with a Master's degree and experience as a 3 year experience as director leading a team of RN Case managers & Social workers required.-- PREFERRED: Master's Degree in Nursing (MSN) or related field (MBA/ MHA).

    Leadership Skill Requirements:-- Maintain and Model Respect, Excellence, Accountability, Compassion and 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:
    • Ability to maneuver through complex, politically charged situations and understand the dynamics and culture of the organization.
    • Ability to anticipate problems and negotiate solutions with peers, senior leadership, and other key stakeholders.
    • Ability to Build Relationships Through Integrity and Trust
    • 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:-- 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.
      Position Type/Expected Hours of Work: Must be willing to work holidays, weekends and provide additional coverage as needed

Keywords: East Orange General Hospital - 300 Central Avenue, East Orange , Director, Case Management, Executive , East Orange, New Jersey

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