Dignity Health Sr Director Care Coordination in SAN FRANCISCO, California

Overview

Dignity Health, one of the nation's largest health care systems, is a 21-state network of 9,000 physicians, 59,000 employees, and more than 400 care centers, including hospitals, urgent and occupational care, imaging centers, home health, and primary care clinics. Headquartered in San Francisco, Dignity Health is dedicated to providing compassionate, high-quality, and affordable patient-centered care with special attention to the poor and underserved. In FY15, Dignity Health provided $1.7 billion in charitable care and services. For more information, please visit our website at www.dignityhealth.org . You can also follow us on Twitter and Facebook .

Responsibilities

Job Summary:

The Regional Senior Director, Care Transitions is responsible for providing leadership in the development, implementation, and oversight of a care coordination model which will support a patient-centered care delivery model across the assigned region. This position is responsible for the development and implementation of standards, systems, policies, and procedures in alignment with organizational strategic initiatives and that is focused on quality and financial outcomes. Specifically, this position leads region wide efforts to optimize care coordination across the care continuum. This coordination ensures a plan of care for patients in all stages of health needs. The plan of care process will also ensure efficient resource utilization, quality outcomes, and maximize reimbursement.

Mission:

Dignity Health and Sponsoring congregations are committed to furthering the healing ministry of Jesus. Resources are dedicated to: delivering compassionate, high-quality, affordable heath services; serving and advocating for our sisters and brothers who are poor and disenfranchised; and collaborating with others in the community to improve the quality of life.

Essential Job Functions:

  • Oversees and/or directs the development, implementation and standardization of region-wide care coordination, utilization management, and social work services policies, procedures and programs in conjunction with related goals and objectives. Ensures compliance with federal and state regulations, as well as established organizational policies and procedures.

  • Establishes and oversees the development and implementation of programs, short and long-range goals and objectives and determines the optimal progression to obtain these goals. Reviews analyses and reports of various activities to determine department progress toward stated goals and objectives.

  • Provides oversight for the medical necessity reviews, denials management, utilization management supporting all areas of the organization within the assigned region. This includes strategy development which will improve reimbursements and reduce denials as related to federal, state and commercial programs in partnership with Dignity Partners.

  • Fosters integration and strong clinical partnerships with Hospitalists, physician advisors, local physician leadership and clinical integration activities in order to optimize care coordination across the care continuum, ensure efficient resource utilization, improve quality outcomes and enhance patient satisfaction.

  • Maintains effective communication and a strong leadership presence with executive partners, senior leaders, internal and external customers to coordinate and adequately address patient care needs.

  • Reviews, prepares, analyzes, and presents reports and recommendations to senior management regarding operations and/or other applicable areas of interest in order to provide concise and accurate information that aids in decision-making. Develops, reviews, and monitors clinical, service and financial outcomes using performance metrics.

Immediate Supervisor:

Vice President, Care Coordination

Job Specifications:

Special Knowledge, Skills, Abilities

  • Extensive understanding of case management practices and knowledge of reimbursement methodologies

  • Effective leadership, human relations and communications skills

  • Ability to identify and address customer needs in a team environment

  • Ability to effectively engage physicians, payers, management level staff, employees, and stakeholders in order to build partnerships, achieve strategic initiatives, and attain organizational goals

  • Ability to manage problems and situations where uncertainty is inherent constructing new and innovative solutions for complex and varying problems and situations while approaching issues/problems by considering the larger perspective or context

  • Analytical and conceptual system-thinking and the ability to manage multiple projects.

Travel

  • Moderate Travel (approx.. 50% of time)

Qualifications

Work Experience

  • Minimum of 5 years experience in healthcare managerial position.

Education

  • Master's degree or equivalent education / experience in nursing or healthcare/business related field.

  • Current Registered Nurse (R.N.) license.

Equal Opportunity

Dignity Health is an Equal Opportunity / Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, protected Veteran status or any other characteristic protected by law.