Director of Case Management (POOL) - Remote in the US - Other Executive

Under the direction of the Vice President of Case Management, the Tenet Director Case Management (Pool) is responsible to oversee hospital case management operations at hospital and/or group level as assigned to fill hospital DCM vacancies. Serves as a member of Case Management leadership team responsible for Level of Care, Length of Stay and Clinical Denial Prevention performance. Leads continuous improvement initiatives and case management revenue cycle and patient throughput best practice strategies in the assigned hospitals to achieve organizational goals through standardized processes.

Key focus on leading case management staff to improve patient throughput while achieving cost efficiency and productivity targets in Tenet hospitals.

Facilitates the assessment, planning and implementation of best practice standardized processes based on identified opportunities that drive improved patient care and capacity.

This leadership position builds strong performance-based relationships, manages through roadblocks and barriers to success, and builds processes and protocols to ensure continued sustainability of initiatives and business processes.

This position will partner with the market and hospital administrative leaders to ensure the strategies are executed at the local level. He/She will work directly with Tenet and Conifer leaders to develop market strategies and tactics that are in alignment with company goals.

Identifies, develops and implements best practices to achieve organizational goals through effectively leading and managing change in a matrix environment. Oversees the implementation of action plans and monitors progress toward goals leading to address barriers and challenges and adjusting as needed in a supportive, synergistic manner. Collaborates with medical and nursing leadership, resource management, case management/social work, discharge planning and utilization management to develop and implement methods to optimize use of hospital services. Works with hospital and group administrative teams to recruit and onboard excellent candidates for key leadership positions.

Manages multi-disciplinary process improvement by utilizing excellent communication and servant leadership skills to challenge status quo and positively influence administrative teams and physicians to change processes to improve performance. May assist with the designing of and providing input needed for implementation and optimization of documentation systems (Cerner, First Net, Careport, Epic, etc.) to standardize workflow and achieve key indicators. Partners with leaders to provide orientation for new team members as needed. Fosters an environment that promotes team member support, partnership, growth and development by assessing the needs of the team and implementing programs to meet those needs. Provides analysis and education regarding regulatory and clinical changes impacting inpatient throughput process and hospital reimbursement. Provides education and tools for educating physicians regarding inpatient throughput process standards. Provides guidance to ensure patient level of care and throughput goals - including length of stay and care variation - are met by working with interdisciplinary teams and entities to coordinate patient flow into and through the hospital.

Works in alignment with assigned leadership teams and consistently demonstrates ability to:

• Successfully lead performance improvement for Level of Care, Length of Stay and Clinical Denial Prevention
• Build effective relationships with hospital and group leaders
• Identify process inefficiencies via root cause analysis and design workflow to address
• Conduct financial analysis and provide budget input as needed
• Develop and implement action plans managing follow up to achieve outcomes
• Implement targeted process changes including ongoing metric monitoring and management to achieve goals and drive improvement

Overall responsibility for the hospital assigned for utilization performance improvement and operational management of the Case Management Department in order to promote appropriate level of care and effective utilization of hospital resources, ensure processes support appropriate reimbursement for services rendered, promote efficient patient throughput, and ensure compliance with all state and federal regulations related to case management services.

Responsible for oversight to integrate national standards for case management scope of services including:

• Utilization Management supporting medical necessity, level of care and denial prevention
• Transition Management promoting appropriate length of stay, readmission prevention and patient satisfaction
• Care Coordination by demonstrating throughput efficiency while assuring care is the right sequence and at appropriate level of care
• Compliance with state and federal regulatory requirements, TJC accreditation standards and Tenet policy
• Education provided to physicians, patients, families and caregivers

Requirements:

• WILL TRAVEL 50% EACH MONTH THROUGHOUT THE US. Motor Vehicle Record (MVR) will be conducted on finalist.
• RN candidates must possess an active RN license and BSN is required. Social Work candidates must be licensed and Master’s prepared (LMSW or LCSW required).
• Strong Presentation skills a must– development and presentation of content.
• A minimum of 5 years Case Management leadership experience in an acute hospital setting required

Preferred:

• Accredited Case Manager (ACM) preferred.
• Multi-site acute-care Case Management leadership experience preferred.
• Advanced degree in Business, Nursing and/or Health Care Administration preferred.

Compensation

• Pay: $125,840 to $201,136 annually. Compensation depends on location, qualifications, and experience.
• Position may be eligible for an Annual Incentive Plan bonus of 10%-25% depending on role level.
• Management level positions may be eligible for sign-on and relocation bonuses.

Benefits

The following benefits are available, subject to employment status:

• Medical, dental, vision, disability, life, AD&D and business travel insurance
• Manager Time Off – 20 days per year
• Discretionary 401k with up to 6% employer match
• 10 paid holidays per year
• Health savings accounts, healthcare & dependent flexible spending accounts
• Employee Assistance program, Employee discount program
• Voluntary benefits include pet insurance, legal insurance, accident and critical illness insurance, long term care, elder & childcare, auto & home insurance.
• For Colorado employees, paid leave in accordance with Colorado’s Healthy Families and Workplaces Act.

Tenet Healthcare/ USPI complies with federal, state, and/or local laws regarding mandatory vaccination of its workforce. If you are offered this position and must be vaccinated under any applicable law, you will be required to show proof of full vaccination or obtain an approval of a religious or medical exemption prior to your start date. If you receive an exemption from the vaccination requirement, you will be required to submit to regular testing in accordance with the law.

Employment practices will not be influenced or affected by an applicant’s or employee’s race, color, religion, sex (including pregnancy), national origin, age, disability, genetic information, sexual orientation, gender identity or expression, veteran status or any other legally protected status. Tenet will make reasonable accommodations for qualified individuals with disabilities unless doing so would result in an undue hardship.