Director, System Care Management

Responsible for developing and implementing standardized tools, roles and systems to support Case Management Services across Trinity Health. Accountable for establishing the metrics and achieving the targets for Case Management Services in collaboration with other System Office and Regional Health Ministry Organization departments and administrators.

POSITION PURPOSE

Responsible for developing and implementing standardized tools, roles and systems to support Case Management Services across Trinity Health.  Accountable for establishing the metrics and achieving the targets for Case Management Services in collaboration with other System Office and Regional Health Ministry Organization departments and administrators.

ESSENTIAL FUNCTIONS

Knows, understands, incorporates and demonstrates the Trinity Health mission, vision and values in leadership behaviors, practices and decisions.

 
Directs case management services across Trinity Health. Leads change effectively through others, assuring sustained process improvements.

Leads operational improvements that facilitate standardization of case management services across the organization and across the continuum of care, directly or through the influence of others at the Regional Health Ministries.

Develops high performing teams in case management across the organization.

Coordinates system-wide reporting of metrics and outcomes, holding Regional Health Ministry and System Office associates accountable for accurate and timely data submissions.  Analyzes and interprets data to direct improvement efforts.

Incorporates and integrates related theories, evidence, practice standards and other established knowledge into standardized processes and functions, applying current trends to the system, where applicable.

Contributes to the ongoing refinement of the strategic plan for case management services, identifying resources needed, risks and contingency plans.

Leads reorganization of structures, policies, practices, etc. to better achieve operational and system targets.

Leads system-wide quarterly/annual director of case management meetings for the purpose of ongoing departmental growth, director growth and development and communication. Provides or facilitates training and coaching of System Office and Regional Health Ministry associates, as needed, to assure sustained improvements.

Monitors effectiveness of tools, roles and systems, working though ambiguous situations to clarify directions and assure compliance.

Oversees compliance with regulations, laws and ethics via audits and direct observation.

Develops a network of case management colleagues across the country to maintain awareness of ongoing regulatory and legislative changes and methods to maintain compliance.

Establishes partnerships with chief nursing officers, physician executives and other key leaders across the organization related to case management services, including Trinity Home Health Services, Trinity Senior Living Communities and other community agencies. Represents case management services at various corporate and hospital committees.

Participates in review of organizational system contracts for issues pertaining to denial management, timelines for authorization of services and other case management-related agreements.

Maintains a working knowledge of applicable Federal, State and local laws/regulations; the Trinity Health Integrity and Compliance Program and Code of Conduct; as well as other policies and procedures in order to ensure adherence in a manner that reflects honest, ethical and professional behavior.

MINIMUM QUALIFICATIONS

Must possess a comprehensive knowledge and experience of post-acute nursing, care management, disease management and clinical practice as normally obtained through

  • Licensed Registered Nurse
  • Bachelor's degree in Nursing; at least 5 years recent experience in case, care or disease management (some of that time is post-acute). Master's degree in Nursing or related Health or Business field preferred.
  • Five (5) or more years of system level leadership experience including responsibility for oversight of direct reports.

  • Working knowledge of chronic conditions, evidence-based guidelines, prevention and wellness.

  • Ability to develop chronic disease management strategies and appropriate protocols and guidelines.

  • Demonstrated program/project management and data analysis skills in population health management, including population health analytics and disease management, and financial optimization.

  • Experience in developing education curriculum and programs for care management/health coaches.

  • Knowledge and experience with performance excellence and lean practices to improve quality and processes.

  • Demonstrated ability to lead large scale transformational change in health care at the organizational/system level and work effectively with all level in the organization, individual and team, across disciplines and geography.

  • Excellent communication and interpersonal skills as demonstrated in oral, electronic and written communication.

  • Must be comfortable operating in a collaborative, shared leadership environment.

  • Must possess a personal presence that is characterized by a sense of honesty, integrity, and caring with the ability to inspire and motivate others to promote the philosophy, mission, vision, goals, and values of Trinity Health.

    PHYSICAL AND MENTAL REQUIREMENTS AND WORKING CONDITIONS

  • Must be able to set and organize own work priorities, and adapt to them as they change frequently.  Must be able to work concurrently on a variety of tasks/projects in an environment that may be stressful with individuals having diverse personalities and work styles. 

  • Must be able to travel to the various Trinity Health sites (at least 50 %) as needed.

  • Must possess the ability to comply with Trinity Health policies and procedures.

  • Must be able to drive as well as fly independently to all Trinity Health RHMs, managing personal travel logistics and access.

The above statements are intended to describe the general nature and level of work being performed by persons assigned to this classification.  They are not to be construed as an exhaustive list of duties so assigned.