DIRECTOR - SYSTEM CARE COORDINATION
Aspirus Health
Compassion. Accountability. Collaboration. Foresight. Joy. These are the Aspirus Core Values; and we are looking for the BEST around to join us as we demonstrate those values Every. Single. Day. Aspirus is seeking a Director - System Care Coordination to join our team at the Aspirus Wausau Corporate Office ! The Director - System Care Coordination is responsible for system-wide Care Coordination functions (Utilization Review, Social Work, Navigation, and Case Management) including the execution of the care coordination strategic plan for the health system and the health plan, which includes organizing and directing an integrated cross-continuum care management and transitions of care program that monitors (on both an individual case and aggregate level) and directs actions to ensure achievement of health system and health plan goals, initiation of change management processes, and implementation of best practices, policies, and procedures. The position is responsible for all Aspirus entities (hospitals, clinics, post-acute care, and contracted care coordination services provided through Aspirus Business Health and the Aspirus Health Plan) and has accountability for the overall supervision of all Registered Nurses, Social Workers, and other healthcare providers in the area under their direction. The Director - System Care Coordination is responsible for recruitment and retention, performance reviews, professional development, and delivery of care management and transition services. Experience/Qualifications:
Essential:
* REGISTERED NURSE LICENSE
- Knowledge of patient care standards and management practices in a healthcare environment normally acquired through completion of a bachelor's degree in Nursing.
- Master's Degree required in business, health care administration, or nursing.
- Extensive knowledge of payer mechanisms and clinical utilization management is required.
- A minimum of five years of experience in care management or utilization review
- A minimum of five to seven years of leadership experience in care coordination, case management, or utilization review, in an integrated healthcare delivery system and/or health plan.
- Possesses an active Wisconsin or Michigan RN nursing license.
- Nationally recognized certification preferred, i.e., Certified Professional in Healthcare Quality (CPHQ), Certified Case Manager (CCM), Certified Professional Utilization Management (CPUM), Certified Professional Utilization Review (CPUR), or Diplomat of American Board of Quality Assurance and Utilization Review Physicians (D-ABQAURP)
- Knowledge of HEDIS, MIPS, Core Measures, NCQA.
- Possesses working knowledge of clinical systems, outcome measures, and processes required along with various patient information systems including Pathways, HEDIS, etc.
- Knowledge and understanding of hospital information systems and their potential uses and benefits.
- Possesses facility for data analysis and interpretation. Must be data driven with a passion for medical management. Possesses ability to organize and present data in a concise and easily understood manner to peers, physicians, and other stakeholders.
- Annual competencies as required by Aspirus and/or various regulatory agencies based on entity and/or job position.
- Full benefits packages available for part- and full-time status.
- PTO accrual from day one!
- Generous retirement plan with match available.
- Wellness program for employees and their families.
Essential:
* REGISTERED NURSE LICENSE
Vacancy posted 4 days ago
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