Care Management Clinical Director

POSITION SUMMARY:

Reporting to the Executive Director/ACNO, the Director of Care Management shall oversee the overall operations of Case Management, Utilization Management and Social Work functions through oversight of both daily and long term activities at Boston Medical Center.  In this capacity, the Director is responsible for developing systems and processes for care/utilization management and social work, as well as managing the department’s activities related to discharge planning and clinical quality improvement.  

The Director evaluates and ensures that hospital resources are used appropriately and effectively.

The Director oversees the collection, analysis, and reporting of financial and quality data related to utilization management, quality improvement, and performance improvement.  The Director is accountable for achieving established performance targets through actively engaging multiple disciplines and professional staff.  The Director must appropriately manage people, relationships, and processes in order to achieve maximized results.  The Director ensures that the department achieves its goals and objectives by engaging internal and external stakeholders in care management processes at Boston Medical Center.  The Director promotes interdisciplinary collaboration, fosters teamwork, and champions service excellence.

Position: Care Management Clinical Director

Department: Case Management Social Work

Schedule: Full Time

ESSENTIAL RESPONSIBILITIES / DUTIES:

Plans, directs, and supervises all aspects of the inpatient level of care program and utilization management. Facilitates growth and development of the care management program consistent with enterprise wide philosophy and in response to the dynamic nature of the health care environment through benchmarking for best practices, networking, quality management, and other activities as needed. Responsible for approving and managing the day-to-day operational budget.  Oversees expense and revenue management, resource (supplies and staff) utilization, and relationship management with payers and network providers. Responsible for departmental personnel functions (e.g. hiring, firing, etc.) in conjunction with the Executive Director/ACNO.  Ensures maintenance of staff qualifications, competencies, staffing levels, workloads and productivity, individual personal development of staff, regulatory compliance, continuing education, performance appraisal system. Acts as liaison to facilitate communication and collaboration between all care partners (e.g., physicians, hospitalists, community social workers, nurses, community resources, etc.). Responsible for leading a high-performance team of ‘system thinkers’ who incorporate leadership principles and vision in performing the functions of care management. Responsible for the Care Management department of Social Work. Responsible for the development and oversight over social service programs to provide resources and support patients and families. Uses data to drive decisions, plan, and implement performance improvement strategies for care management. Utilizes patient focused, continuous improvement techniques to reach key performance targets; seizes opportunities to resolve/improve processes.  Ensures interdepartmental collaboration, customer service, regulatory compliance and monitoring of key systems.  Reviews and acts upon key performance management indicators related to the strategic imperatives of the entire system. Responsible for overseeing the education of physicians, managers, staff, patients, and families related to the care management and Utilization Management process.  Participants in this evolutionary process by constantly identifying future needs of current customers and/or identifying potential new customers. Ensures that the department achieves the vision, goals and objectives of Boston Medical Center by developing the scope of service, establishing effective relationships with physicians, collaborating with other disciplines, strengthening interdisciplinary processes, managing flexible staffing/workload and overseeing care coordination and outcomes management duties.  Conducts research as necessary to ensure that departmental practices are current and continue to meet the needs of the organization. Coordinates all campus-wide Care Management functional reporting related to utilization management, social work services, case management, discharge planning, resource coordination, and quality improvement. Builds, establishes, fosters, develops, and nurtures relationships with multiple internal and external stakeholders to garner satisfactory customer results.  Support the needs of physicians to provide care for patients in the most clinically appropriate setting by developing and implementing care management and outcomes management practices.  Work with physicians as part