QUICK HITTING SURVEY: Care Coordination/Case Management The Academy Executive Summary Methodology In August 2014, The Health Management Academy surveyed 27 Leading Health Systems regarding the roles and responsibilities of the VP or SVP of Care Coordination and Case Management. With a 48% response rate, 13 Chief Human Resources Officers responded. Key Findings Among 13 health systems, 54% have a VP or SVP of Care Coordination and Case Management (n=5) or an individual with a similar title (n=2) in their health system. Two (15%) of the responding health systems attached a job description for their administrator of Care Management and Transitions and AVP of Care Management, respectively. Survey Results Do you have a VP or SVP of Care Coordination/Case Management in your Health System? 46% 15% 39% VP or SVP of Care Coordination and Case Management Similar Position No VP/SVP/Similar Position Of the 13 responding health systems, 39% (n=5) have a VP or SVP of Care Coordination and Case Management and 15% (n=2) do not have a VP or SVP but do have individuals with a similar title (Administrator of Care Management and Transitions, AVP of Care Management). These two health systems provided job descriptions, which are attached. 1 of 1 Health Management Academy, August 2014.
Job Description Oracle Job Title(s) Integrated Care Management AVP Job Code 4255 (L.17/Nurse/CO) Date Reviewed 2013 June 27 FLSA Exempt Position Purpose This position will oversee the care management functions across all divisions for Intermountain Healthcare. This position sets the vision for all Integrated Care Management programs and, in collaboration with clinical leadership, develops the infrastructure and strategy for Integrated care Management initiatives throughout the system. Ensures system-wide compliance with all relevant governmental regulations, contractual requirements, as well as accreditation requirements as identified by the organization (CMS, NCQA, JCAHO, etc.). Develops an Integrated Care Management learning culture for Intermountain by implementing and overseeing programs that are designed to ensure patients receive the right service at the right time from the right provider in the right setting. Works collaboratively with all disciplines, clinical programs and clinical services to assure a partnership around Integrated Care Management. Scope This is a system-wide leadership role reporting to the Vice President of Clinical Operations. Job Essentials 1. Accountable for developing a measurement and evaluation plan for all Integrated Care Management goals and developing programs that ensure high-quality clinical outcomes for patients of care management programs. 2. Directs the development, implementation and monitoring of Integrated Care Management initiatives through collaboration with operations and clinical leadership teams. 3. Develops and directs programs that strive for optimal allocation of resources so that patients receive the right service at the right time from the right provider in the right setting. 4. Is responsible for the achievement of total cost of care targets for patients receiving care management services and high patient or member satisfaction with care management programs 5. Works collaboratively with nursing, clinical programs, clinical services, compliance, risk management, Chief Medical Office, regional operations, health plans and the community to understand system-wide trends, to improve care and foster an interdisciplinary approach to Integrated Care Management across Intermountain. 6. Stays abreast of changes to the healthcare environment, care management and healthcare reimbursement innovations through local, regional and national networking. 7. Supports best practice through policy standardization, appropriate data collection and analysis, IS support and clinical education collaboration. 8. Leads and supervises care management professionals and is responsible for staffing, performance management and development of that team. Minimum Requirements
Master s Degree in Nursing/Social Work or Healthcare Administration. Degree must be obtained through an accredited institution. Education is verified. Must hold and maintain a professional license in nursing or as an LCSW. Ten (10) years of professional progressive experience in health care delivery or healthcare management Five (5) years of experience leading case management, disease management or care coordination programs requiring knowledge of the current healthcare environment, healthcare regulatory matters and healthcare reimbursement. Experience in a role requiring strategic thinking and planning skills and the ability to develop proposals, pilots and projects from conception to implementation. Experience in directing other clinical areas, working closely with physicians, and developing clinical strategies, implementing operational efforts and measuring outcomes. Experience achieving results in both line management and matrix management environments. Experience using word processing, spreadsheet, database, internet, e-mail and scheduling applications. Experience in a role requiring effective verbal, written and interpersonal communication skills. Preferred Qualifications Professional experience working in an integrated delivery system that includes a health plan. Experience evaluating technology solutions to support care management functions Experience with developing collaborative relationships with community organizations to address healthcare needs across the continuum Physical Requirements Seeing Speaking Hearing / Listening Manual Dexterity The primary intent of this job description is to set a fair and equitable rate of pay for this classification. Only those key duties necessary for proper job evaluation and/or labor market analysis have been included. Other duties may be assigned by the supervisor.
MULTICARE HEALTH SYSTEM MultiCare believes that each employee makes a significant contribution to our success. Contributions can be within and outside of assigned responsibilities. It is our expectation that each employee will offer his/her services wherever and whenever necessary to ensure the success of our endeavors. JOB TITLE: Administrator of Care Management and Transitions DEPARTMENT: Care Management POSITION CODE: A4012 FLSA STATUS: Exempt REPORTS TO: Sr Vice President/Chief Nurse Exec. DATE: February 2014 GENERAL DESCRIPTION The Administrator for Care Management and Transitions is accountable for strategic planning, oversight of program development, business planning, policy setting, budget planning, expense control and the coordination of the system-wide approach to delivering services for the care of patients across the continuum throughout MultiCare Health System. This includes responsibility for Case Management, Utilization Management, Social Work, Transitions of Care/Complex Care Support Team Program, MultiCare One Call, Palliative Care and a strong linkage to Home Health/Hospice. Additional duties include planning, developing, and evaluating current nursing and system level collaboration/model of care approaches and future strategies. This position works closely with management, staff, and physicians requiring the development of rapport and the maintenance of professional relationships. PRINCIPAL ACCOUNTABILITIES Directs and provides leadership to the overall operation, administration, financial and human resources of all care management and transition services departments, establishing and implementing policies and standards to integrate the multiple departments, goals and objectives Provides strategic vision to operationalize standard processes such as handoffs and transitions throughout the entire care continuum Plans and directs MHS-wide improvement activities while ensuring policies and standards are met Approves policy and procedural changes. Ensures care management and transition services and practices are integrated throughout MHS Orchestrates the planning and development in the delivery of all care management services to achieve system wide goals and objectives Ensures MHS compliance with state and federal regulations, The Joint Commission and other accreditation organization standards Monitors technological advances to ensure departments are supported and new innovations are implemented Provides direction and leadership to assigned services in the maintenance of leading edge programs and services to keep MHS in a maximum competitive position. Facilitates multidisciplinary discussions with overlapping departments to increase efficiency and reduce duplication of efforts related to charting, completing Mocha tickets, reporting and financials. Creates and monitors respective department budgets, revenues and expenses with comparison to historical data. Implements actions as indicated.
MULTICARE HEALTH SYSTEM CARE MANAGEMENT ADMINISTRATOR CARE MANAGEMENT & TRANSITIONS PAGE 2 Reviews and monitors respective department quality improvement programs. Builds positive relationships with medical staff, hospital staff, post-acute providers, payers, and all others involved throughout the continuum of care. Adheres to MHS Attendance and Punctuality Policy and Procedure standards. Maintains reliable attendance Contributes to the success of the organization by meeting organizational competency expectations and core values (Respect Integrity Stewardship Excellence Collaboration Kindness), continuously learning, and by performing other duties as needed or assigned LEADERSHIP COMPETENCIES Personal Competencies Integrity Accountability Self-Development Interpersonal Competencies Communication Collaboration Fostering Teamwork Developing Others Organizational competencies Customer Focus Quality and Strategic Focus Financial and Operational Management MINIMUM QUALIFICATIONS KNOWLEDGE, SKILLS, & ABILITIES - Knowledge of complex health care management and transitional support systems - Knowledge of current health care trends, operations and management systems - Knowledge of the principals of Information Management in order to effectively analyze and make decisions - Skill in analytical and critical thinking with an ability to effectively and accurately analyze resource requirements for existing and future initiatives; to effectively analyze risks and opportunities, selecting appropriate initiatives; to effectively present findings of a complex analysis - Skill in project management with the ability to lead in the development of highly functional teams, establishing and attaining achievable time lines, analyzing resources required for successful completion, monitoring progress and reporting progress. - Skill in providing leadership and mentoring to the staff - Skill in directing the work and activities of staff and with the ability to effectively delegate - Skill in interpersonal relationships with emphasis on professional interaction, consensus building and negotiation
MULTICARE HEALTH SYSTEM CARE MANAGEMENT ADMINISTRATOR CARE MANAGEMENT & TRANSITIONS PAGE 3 - Ability to creating high-performing teams and/or work in a cross functional team environment, both within the department, and within the system Skill in time management and ability to meet deadlines Ability to set priorities and use good judgment Ability to be caring, sympathetic, calm, and able to work as part of a team EDUCATION & EXPERIENCE Masters degree in Nursing, Business, Health Administration, or other area relating to clinical care Ten years of experience in a hospital or health system with oversight of direct patient care Six years of leadership experience managing a variety of clinical departments required Five years of Case or Care Management experience required Five years experience developing, implementing, and tracking clinical strategies RN license preferred Job descriptions represent a general outline of job duties, functions and qualifications. They are not intended to be comprehensive in nature. In addition, jobs evolve over time and therefore their description may not reflect the precise nature of the position at a given point in time. It is MultiCare's policy to base hiring decisions solely on the individual's ability to perform essential job functions. Persons with disabilities are eligible for this position provided they can perform those functions with reasonable accommodation.