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Providence

Not-for-profit health system with hospitals

Senior Director Care Management

Medical, Clinical & VeterinaryConfirmed live in the last 24 hours
Full-timeAnchorage, AK, USAHybrid

About the Job

Requirements

  • A bachelor's degree in nursing is required.
  • A master's degree in nursing, business administration, health care administration, or a related field is required.
  • An Alaska Registered Nurse license is required upon hire.
  • National Provider Basic Life Support certification from the American Heart Association is required upon hire.
  • Accredited Case Manager certification or Certified Case Manager certification is required within one year of hire.
  • Six years of clinical or operational leadership experience managing a variety of patient care services in a complex healthcare environment are required.
  • Five years of director- or manager-level experience in case management are required.
  • The candidate must be able to interpret, analyze, and use data to improve service-area operating efficiencies focused on care delivery.
  • The candidate must know state and federal regulations, including Medicare and Medicaid.
  • The candidate must understand clinical management of complex healthcare needs and diagnoses.
  • The candidate must work cooperatively with others to use appropriate strengths, knowledge, and cooperation to improve performance.

Responsibilities

  • Oversee the managers and supervisors of Care Management at each ministry and collaboratively lead, coordinate, and support care management operations with the Executive Director of Care Management and the Directors of Utilization, Appeals, and Clinical Training.
  • Provide guidance and oversight to Care Management on caregiver engagement, department operations, length-of-stay and readmission improvement opportunities, and strategies to help the department and caregivers meet goals and outcomes.
  • Provide service-area leadership and strategic planning to operationalize standard care management services across the division and coordinate care management across the continuum.
  • Oversee service-area development of goals, creation and implementation of action plans, and program evaluation.
  • Sponsor and lead process improvement and change to achieve operational excellence; identify inefficient or ineffective systems, processes, practices, and functions; lead corrective action; and support multidisciplinary work teams in correcting issues and monitoring results.
  • Participate in division-wide and service-area care management teams and serve as a liaison and resource to internal and external stakeholders on daily care management operations.
  • Provide consultative support to service-area leadership and promptly raise concerns and requests for consultation or support to regional leadership.
  • Conduct ongoing audits to monitor performance and regulatory compliance and escalate findings as necessary.
  • Work with identified service-area physicians and chief nursing officers to coordinate efforts.
  • Ensure compliance with federal, state, and local requirements.
  • Promote and maintain positive relationships with continuum-of-care providers.
  • Collaborate with Education to develop and update standard work and policies for Care Management.
  • Measure, analyze, and report key care management metrics across the care continuum.
  • Facilitate problem solving with other departments as indicated.
  • Educate managers, staff, physicians, and community stakeholders about regulations, requirements, and best practices.
  • Identify opportunities to coordinate services between inpatient and outpatient settings.
  • Develop relationships with leadership across the continuum within the service area.
  • Standardize Care Management across the service area to decrease total cost of care.
  • Maintain confidentiality of information related to patients, medical staff, employees, and other appropriate information.
  • Demonstrate service excellence and positive interpersonal relations with patients, families, members, employees, managers, medical staff, volunteers, and community members to maximize productivity and positive relations.
  • Maintain knowledge of work-appropriate environment-of-care programs, comply with policies, and report unsafe conditions.
  • Oversee consistent service-area and system reporting for care management outcomes, collaborating on management, engagement, and ongoing development of technology capabilities such as EPIC to support care management functions, productivity, and other work requirements.
  • Oversee complex case management issues, outliers, and ethics issues.

Desired Qualifications

  • A master's degree from an accredited or approved school of nursing is preferred.
  • Coursework in case management, managed care, and/or utilization management, and experience in varied cross-continuum care settings such as acute and outpatient care, are preferred.
  • Experience in a variety of healthcare settings, from acute-care inpatient facilities to outpatient clinics, is preferred.

About the Company

Providence

Not-for-profit health system with hospitals

Providence Health & Services is a not-for-profit healthcare system operating 51 hospitals and over 1,000 clinics in seven western states, offering outpatient care, hospital care, home health, hospice, substance abuse programs, and mental health services. Care is delivered by about 122,000 caregivers, with revenue from patient services reinvested into ongoing care and community programs, all rooted in faith-based values. It differentiates itself by reinvesting earnings into care and community services rather than distributing profits, and by leveraging a large, integrated network to pursue scale and efficiency. Its goal is to strengthen financial stability while expanding access and quality of care for diverse communities.

Company size
10,001+
Company stage
Not listed
Total funding
Not listed
Headquarters
Renton, WA
Founded
1859

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