Baylor Scott & White Health
Director of Comprehensive Care Management
Baylor Scott & White Health, Mckinney, Texas, United States, 75070
Overview
JOB SUMMARY
Directs the Comprehensive Care Management (CCM) and Support Services for Baylor Scott and White Health (BSWH). This role plans, develops, and implements the continuum of care and case management functions, which may include case management, social services, patient care coordination, patient access, utilization management, and discharge planning. It may also oversee support services such as administrative support of supportive and palliative care, regulatory and compliance, patient safety and quality, or other patient care support activities. The role directs the management and analysis of case management to improve the transition of clinical care and develops and implements comprehensive care programs, policies, procedures, and initiatives that balance cost effectiveness with quality care. It monitors patient care activities and financial effectiveness of care, and develops guidelines for working with insurers, managed care organizations, referral providers, patients, and families. The position ensures compliance with applicable regulations and BSWH policies, procedures, and performance standards, and strives to deliver high-quality patient care that meets the needs of patients, families, physicians, the hospital, and BSWH. An entity Director translates and implements strategic plans and objectives for the area of responsibility. It involves making final decisions on operational matters, planning and executing projects and initiatives, and directing department operations including staffing, processes, budgets, and costs. Leaders in this role guide subordinate staff and may supervise managers or supervisors, reflecting a larger and more complex organization or functional area than a manager. Essential Functions of the Role
Directs CCM and support services for the assigned area of responsibility for BSWH. Recommends and implements strategic and operational plans and priorities for CCM programs aligned to BSWH objectives. Directs an interdisciplinary, integrated model of comprehensive care and discharge planning with licensed professionals (RNs and social workers) and para-professional staff who support them. Directs CCM services that include discharge planning, care coordination, and social work to advocate for patients and families and meet their needs. Develops and implements CCM programs and initiatives to ensure effectiveness and appropriateness of services. Leads development with a focus on census management, patient care outcomes, and other key care indicators. Identifies and resolves CCM service problems and inpatient care situations that arise. Implements and monitors CCM practice policies, procedures, and processes to comply with legal and regulatory requirements affecting CCM programs. Collaborates with cross-functional teams and hospital operations to identify improvement opportunities, facilitate process changes, and lead action plans with follow-up. Leads continuous improvement initiatives and Lean activities for CCM processes and service delivery. Key Success Factors
Bachelor’s degree in nursing, social work, or related field preferred; Master’s degree preferred. 3+ years of experience in case management, social work, utilization review, or related field. Experience in a leadership role preferred. Registered Nurse (RN) or Licensed Clinical Social Worker (LCSW) required. Licensed Master Social Worker (LMSW) preferred. Knowledge of case management, discharge planning, transition of care, transfer coordination. Excellent verbal, written, interpersonal, and presentation skills. Ability to lead and influence multi-disciplinary teams in delivering a comprehensive care program. Benefits
Our benefits are designed to help you live well no matter where you are on your journey. For full details on coverage and eligibility, visit the Baylor Scott & White Benefits Hub to explore offerings, which may include: Immediate eligibility for health and welfare benefits 401(k) savings plan with dollar-for-dollar match up to 5% Tuition Reimbursement PTO accrual beginning Day 1 Note: Benefits may vary based upon position type and/or level Qualifications
Education - Bachelor’s degree or 4 years of work experience above minimum qualification Experience - 3 years of experience Certification/License/Registration - LCSW, LMSW, RN: RN or LCSW or LMSW required If RN, Bachelor’s degree in Nursing required If Social Worker, Bachelor’s degree in Social Work required
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JOB SUMMARY
Directs the Comprehensive Care Management (CCM) and Support Services for Baylor Scott and White Health (BSWH). This role plans, develops, and implements the continuum of care and case management functions, which may include case management, social services, patient care coordination, patient access, utilization management, and discharge planning. It may also oversee support services such as administrative support of supportive and palliative care, regulatory and compliance, patient safety and quality, or other patient care support activities. The role directs the management and analysis of case management to improve the transition of clinical care and develops and implements comprehensive care programs, policies, procedures, and initiatives that balance cost effectiveness with quality care. It monitors patient care activities and financial effectiveness of care, and develops guidelines for working with insurers, managed care organizations, referral providers, patients, and families. The position ensures compliance with applicable regulations and BSWH policies, procedures, and performance standards, and strives to deliver high-quality patient care that meets the needs of patients, families, physicians, the hospital, and BSWH. An entity Director translates and implements strategic plans and objectives for the area of responsibility. It involves making final decisions on operational matters, planning and executing projects and initiatives, and directing department operations including staffing, processes, budgets, and costs. Leaders in this role guide subordinate staff and may supervise managers or supervisors, reflecting a larger and more complex organization or functional area than a manager. Essential Functions of the Role
Directs CCM and support services for the assigned area of responsibility for BSWH. Recommends and implements strategic and operational plans and priorities for CCM programs aligned to BSWH objectives. Directs an interdisciplinary, integrated model of comprehensive care and discharge planning with licensed professionals (RNs and social workers) and para-professional staff who support them. Directs CCM services that include discharge planning, care coordination, and social work to advocate for patients and families and meet their needs. Develops and implements CCM programs and initiatives to ensure effectiveness and appropriateness of services. Leads development with a focus on census management, patient care outcomes, and other key care indicators. Identifies and resolves CCM service problems and inpatient care situations that arise. Implements and monitors CCM practice policies, procedures, and processes to comply with legal and regulatory requirements affecting CCM programs. Collaborates with cross-functional teams and hospital operations to identify improvement opportunities, facilitate process changes, and lead action plans with follow-up. Leads continuous improvement initiatives and Lean activities for CCM processes and service delivery. Key Success Factors
Bachelor’s degree in nursing, social work, or related field preferred; Master’s degree preferred. 3+ years of experience in case management, social work, utilization review, or related field. Experience in a leadership role preferred. Registered Nurse (RN) or Licensed Clinical Social Worker (LCSW) required. Licensed Master Social Worker (LMSW) preferred. Knowledge of case management, discharge planning, transition of care, transfer coordination. Excellent verbal, written, interpersonal, and presentation skills. Ability to lead and influence multi-disciplinary teams in delivering a comprehensive care program. Benefits
Our benefits are designed to help you live well no matter where you are on your journey. For full details on coverage and eligibility, visit the Baylor Scott & White Benefits Hub to explore offerings, which may include: Immediate eligibility for health and welfare benefits 401(k) savings plan with dollar-for-dollar match up to 5% Tuition Reimbursement PTO accrual beginning Day 1 Note: Benefits may vary based upon position type and/or level Qualifications
Education - Bachelor’s degree or 4 years of work experience above minimum qualification Experience - 3 years of experience Certification/License/Registration - LCSW, LMSW, RN: RN or LCSW or LMSW required If RN, Bachelor’s degree in Nursing required If Social Worker, Bachelor’s degree in Social Work required
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