Seeking high-level Senior Nurse leader to provide leadership and direction of the case management plan across the enterprise-wide continuum of care to meet the company's mission, values, goals, and objections.
- Reporting to the Chief Financial Officer, the Executive Director of Population Health/Case Management will be responsible for the development, implementation and ongoing review of the enterprise-wide continuum of care case management integrated system.
- Participates with leaders of the hospitals, medical staff, medical group practices, managed care, Post-acute care, community stakeholders and clinical areas to achieve optimal clinical and financial outcomes.
- Directs and coordinates the planning, organizing, prioritizing, implementation and evaluation of the activities and associates engaged in care management.
- Assures compliance and oversees the operational processes of case management consistent with regulatory and third party payer requirements and regulations.
- Highly engaged with Payors and Value-based contracts along with ACO and ACO committees to Proactively Manage the population that has accepted responsibility for and ensure the Value-based goals are being achieved.
Scope of the position includes:
Hospital utilization review, transition planning/social services function
Care Coordination Institute (CCI) long-term complex case management and risking risk intervention program
Transitional care program
Post-Acute Care Team (PACT) readmission reduction program
Palliative Care Services (inpatient and outpatient)
Hospital-based chronic disease management services
Post-hospital discharge call back/follow up programs
Aligned post-acute partner relationships
Education and Experience
Master’s Degree or another advanced degree in Nursing required
5+ years minimum of Case Management experience
3+ years minimum of management experience required
Registered Nurse in the State of Indiana
Case Management leadership experience and certification strongly preferred.
Proven experience involving flexibility, resilience, and ability to be successful with increasing responsibility in a dynamic healthcare environment
Insurance background is also very helpful.