Director of Care Coordination

Essential Job Statements

• Leadership and Strategy: Execute care coordination strategies that support inpatient care coordination nursing, outpatient nurse navigation, or pediatrics care coordination nursing and nurse navigation, and social work programs to improve patient outcomes and optimize resource utilization.

• Clinical Operations: Provides leadership for the development and implementation of clinical workflows to ensure efficiency, effectiveness, and compliance with regulatory/accreditation standards (State Health Department, OSHA, CMS, TJC) and standards of care within inpatient, outpatient, or pediatric settings. Establish protocols for seamless patient transitions within inpatient units, outpatient units, or pediatrics settings across the health system to ensure high quality care across the continuum. Establish and lead ad hoc committees or task forces to identify and address performance gaps or opportunity gaps within the department. This involves coordinating cross-functional teams, facilitating discussions, and implementing action plans to enhance departmental performance and capitalize on opportunities for improvement.

• Staff Management: Cultivates a culture of safety by maintaining adequate staffing levels and holding inpatient nursing, outpatient nurse navigation, or pediatrics nursing, nurse navigation, and social work care coordination managers accountable to policies aimed at improving high quality care. Provide mentorship and professional development opportunities to managers. Work closely with inpatient managers, outpatient managers, or leadership to develop recruitment and retention strategies, fostering a culture of excellence and continuous improvement. Patient-Centered Care: Develops and implements care transition programs, including utilization review, intake or discharge planning, and working with managed care companies and post agencies and community partners. Develops continuity of care by streamlining communication between inpatient and outpatient teams, or between pediatrics settings.

• Fiscal Stewardship: Collaborates with payers on mechanisms to reimburse for activities that reduce cost and utilization. Shows fiscal responsibility by reducing program-operating costs and improving operational efficiencies. Balances clinical and financial outcomes with patient and family needs to ensure optimal results.

• Collaboration: Serve as a liaison between inpatient managers, outpatient managers, or pediatrics leadership, and senior leadership to ensure cohesive operations and shared objectives.

• Data Analysis and Reporting: Leverage data-driven insights to monitor and enhance care coordination performance. Develop and implement a comprehensive quarterly reporting system to track and analyze key performance metrics, ensuring timely and accurate submission of reports to the senior director. This includes identifying performance trends, providing actionable insights, and recommending improvements to enhance overall departmental efficiency and effectiveness.

• Policy Development: Provides oversight and development of continuous quality improvement processes to update policies and procedures to ensure they reflect current best practices and regulatory requirements. Engage with key stakeholders to gather feedback and incorporate their insights into policy revisions. Monitor the implementation of policies to ensure compliance and effectiveness and adjust as necessary to address emerging challenges and opportunities.

Patient Population

Demonstrates the knowledge and skills necessary to provide equitable care appropriate to the age of the patients served on their assigned unit.

Demonstrates knowledge and related competencies of the principles of growth and development of the life span and possesses the ability to assess data reflective of the patient's status and interprets the appropriate information needed to identify each patient's requirements relative to their age, specific needs and to provide the equitable care needed as described in departmental policies and procedures.

Neonates (0-4 weeks)

Infant (1-12 months)

Pediatrics (1-12 years)

Adolescents (13-17 years)

Adults (18-64 years)

Geriatrics (65 years and older)

Employment Qualifications

Education Required:

Master's in healthcare management, nursing, social work, business administration, or related field.

REGISTERED NURSE Masters Degree in Nursing or a related field. from an accredited school.
If Masters Degree is not in Nursing, then it is a requirement to have a Baccalaureate Degree in Nursing from an accredited school.

or

BEHAVIORAL HEALTH/CLINICAL SOCIAL WORK: Master's Degree in Social Work from a Council on Social Work Education (CSWE) accredited program.

Education Preferred:

Licensure Required:

REGISTERED NURSE: current RN licensure in Virginia

BEHAVIORAL HEALTH/CLINICAL SOCIAL WORK: current LCSW

Licensure Preferred: N/A

Certification Required: N/A

Certification Preferred: N/A

Minimum Qualifications

Years and Type of Experience Required:

7 years of related experience, including 3 years of management experience in a healthcare setting.

Other Knowledge, Skills and Abilities Required:

• Proven knowledge of inpatient, outpatient, and/or pediatrics care management strategies, regulatory requirements, and current healthcare trends.

• Strong knowledge of healthcare regulations, accreditation requirements, and best practices in care management.

• Proven ability to lead teams and manage complex projects.

• Exceptional leadership skills with the ability to motivate, manage, and develop teams.

Other Knowledge, Skills and Abilities Preferred:

• Academic healthcare experience or complex health system experience.

• Director of Care Coordination (Outpatient): Experience with Population Health or other Valued Based Models.

• Director of Care Coordination (Pediatrics): Experience with Population Health, Clinically Integrated Networks or other Valued Based Models.Pediatric behavioral health experience preferred.

• Strong analytical skills and experience in managing performance-based metrics.

• Proficiency in data analysis and care coordination software tools.

• Excellent communication and interpersonal skills to foster collaboration across multidisciplinary teams.

Working Conditions

Periods of high stress and fluctuating workloads may occur.

General office environment.

May be exposed to physical altercations and verbal abuse.

Required to car travel to off-site locations, occasionally in adverse weather conditions.
May be exposed to high noise levels and bright lights.

May be exposed to limited hazardous substances or body fluids. *

May be exposed to human blood and other potentially infectious materials. *

May have periods of constant interruptions.

* Individuals in this position are required to exercise universal precautions, use personal protective equipment and devices, and learn the policies concerning infection control.

Physical Requirements

Physical Demands: Lifting/ Carrying (0-50 lbs.), Climbing

Work Position: Sitting, Walking, Standing

Additional Physical Requirements/ Hazards

Physical Requirements: Manual dexterity (eye/hand coordination), Hear alarms/telephone/tape recorder, Finger Dexterity, Repetitive arm/hand movements, Color Vision, Acuity - far, Acuity - near

Hazards: Use of Latex Gloves

Mental/Sensory -Emotional

Mental / Sensory: Strong Recall, Reasoning, Problem Solving, Hearing, Speak Clearly, Write Legibly, Reading, Logical Thinking

Emotional: Fast-paced environment, Steady Pace, Able to Handle Multiple Priorities, Frequent and Intense Customer Interactions, Noisy Environment, Able to Adapt to Frequent Change

EEO Employer/Disabled/Protected Veteran/41 CFR 60-1.4.