Director of Care Management

Thanks for your interest in Children's Mercy!

Do you envision finding a meaningful role with an inclusive and compassionate team? At Children’s Mercy, we believe in making a difference in the lives of all children and shining a light of hope to the patients and families we serve. Our employees make the difference, which is why we have been recognized by U.S. News & World Report as a top pediatric hospital, for eleven consecutive years.

 

Children’s Mercy is in the heart of Kansas City – a metro abounding in cultural experiences, vibrant communities and thriving businesses. This is where our patients and families live, work and play. This is a community that has embraced our hospital and we strive to say thanks by giving back. As a leader in children’s health, we engage in meaningful programs and partnerships throughout the region so that we can improve the lives of children beyond the walls of our hospital.

Overview

The Director of Care Management responsible for providing leadership, strategic planning, and oversight of daily operations of the case management department which includes utilization management, care progression and discharge planing promoting interdisciplinary collaboration, teamwork, and championing service excellence. The Director of Care Management works under the strategic direction of the Senior Director of Care Management and responsibilities include appropriate and effective use of the department resources, oversight of collection, analysis and reporting of financial data, quality improvement and performance improvement and ensuring compliance and accountability of all functions and services. The position will ensure consistency in workflows, documentation, quality and outcomes for case management across the health system.

 

At Children’s Mercy, we are committed to ensuring that everyone feels welcomed within our walls. A successful candidate for this position will join us as we strive to create a workplace that reflects the community we serve, as well as our core values of kindness, curiosity, inclusion, team and integrity.

 

Additionally, it’s important to us that we remain transparent with all potential job candidates. Because we value the safety of the patients and families we serve, as well as the Children’s Mercy staff, we want to let you know that the seasonal influenza vaccine is a condition of employment for all employees in our organization. New employees must be willing to be vaccinated if found non-immune to measles, mumps, rubella (MMR) and chicken pox (varicella) and/or without evidence of tetanus, diphtheria, acellular pertussis (Tdap) vaccination since 2005. If you are selected for this position, you will be asked to supply your immunization records as proof of vaccination. If you and have any concerns about receiving these vaccines, medical and/or religious exemptions can be further discussed with Human Resources.

Responsibilities

Strategic Leadership

• Develops and implements outcome and in-process metrics for Care Management aligned with the organization’s true North pillars.
• Provides direction to achieve the goals and objectives based on metrics
• Develops and implements standard practices that represent best practice in patient status recommendations, medical necessity review, pre-bill denial avoidance and denial management.
• Partners with Revenue Cycle, Payor Relations, HIM and Risk Mangement in support of utilization management and high-risk patients
• Creates accountability and escalation pathways for resolving care coordination and care progression barriers throughout the health system.
• Accountable and responsible for length of stay and resource reduction strategies making recommendations for process improvement to maximize efficiency and cost effectiveness
• Contributes as a partner with Senior Leadership as healthcare subject matter expert.
• Acts as liaison to facilitate communication and collaboration between all care partners (internal and external partners, etc.)
• Establishes relationships with payors to promote continuum of care alignment and strategies.
• Facilitates development of trusting relationships and partnerships with physicians, nursing, payers, patients, and coworkers.
• Utilizes knowledge of hospital processes, clinical patient care, state and federal regulations and payer requirements to participate and guide leadership of interdisciplinary teams towards improvement of patient flow and patient progression, clinical outcomes and efficiency of inpatient stays. Continually strives to integrate case management and social work across the system.
• Ensures that all case management processes and outcomes meet or exceed regulatory requirements.
• Directs and oversees the activities of all work groups and task forces that are structu