Senior Nursing Director – Care Management – Maitland(
Professional - Non-Clinical:Director/Executive
Senior Director – Care Management – Maitland
Florida Hospital Lake View Plaza seeks to hire Senior Nursing Director – Care Management who will embrace our mission to extend the healing ministry of Christ.
Established in 1908, Florida Hospital is one of the largest not-for-profit healthcare systems in the country, caring for more than a million patients each year. The 2,675-bed acute-care medical facility, comprised of nine hospitals, has been recognized by U.S. News & World Report as one of the best hospitals in the country for over 10 years. It serves as a community hospital for Greater Orlando and as a major tertiary referral hospital for Central Florida and much of the Southeast, the Caribbean and Latin America.
The Care Management Department is located in every campus throughout the Florida Hospital system. Our objective is to create a collaborative process of assessment, planning, facilitation, care coordination, evaluation, and advocacy for services to meet individuals and family's comprehensive needs. Care Management is an integrated department with physicians, clinical/nursing teams, ancillary departments and the revenue cycle teams. Care management meets the needs of our patients, families and significant others throughout the care continuum including the post-discharge needs.
Flexible days and hours
Under minimal supervision, the Senior Director – Care Management - System develops and coordinates implementation of complex hospital strategies, involving physicians and multiple hospital departments, to assure appropriate utilization of hospital resources, appropriate level of care for patients, and appropriate discharge planning. Responsible for assuring appropriateness of patient admissions based on severity of illness/intensity of service criteria. Facilitates case reviews based on medical screening criteria and oversees denial management process to third party payers to ensure optimum reimbursement. Responsible for case management, utilization review and social worker/discharge planning processes for Florida Hospital business units. Responsible for building and maintaining positive working relationships with medical staff, external agencies (ECF's, sub-acute facilities, Home Care) and all members of the health care team. Responsible for on-going operations, short- term and long-term planning and development of the outcomes management service area for Florida Hospital. Develops and implements state-of-the-art performance improvement and outcomes management programs that enhance the operational, financial, and clinical performance of the organization. Implements and oversees the maintenance and use of databases and systems for measuring, monitoring, and tracking utilization and performance changes. Leads and directs cross-functional teams for achieve results. Works closely with physicians and the campus leadership team on utilization/case management issues. Actively participates in outstanding customer service and accepts responsibility in maintaining relationships that are equally respectful to all.
Knowledge of Case Management, Utilization Management, Discharge Planning, Social Work, and Patient Placement. Performance Improvement, Outcomes, and Quality Management.
Skilled in providing an environment which promotes patient satisfaction and the achievement of clinical outcomes
Provides an environment which promotes and supports the retention, growth and development of employee skills, knowledge and efficiencies.
Ability to be innovative and creative with solution development and implementation to achieve desired outcomes.
Ability to interpret and process data in an analytical manner.
Ability to work in a matrix-management environment to achieve organizational goals
Computer operational skills, understanding of database systems
Strong organization skills
Excellent analytical and problem-solving skills
Effective oral and written communication skills, with the ability to articulate complex information in understandable terms to all levels of staff
Bachelor's degree in Nursing
Seven to ten years' acute care hospital clinical experience
Five years' progressively responsible leadership experience
Previous case management, utilization management, or related discipline experience
Master's degree in Nursing, Business, or health-related field(preferred)
Licensure, Certification, or Registration Required:
Current, valid State of Florida license as a registered professional nurse
Nursing specialty certification (preferred)
Case management certification: Accredited Case Manager (ACM), Certified Case Manager (CCM), Board Certified in Case Management (RN-BS) (preferred)
Demonstrates through behavior Florida Hospital's Core Values of Integrity, Compassion, Balance, Excellence, Stewardship and Teamwork as outlined in the organization's Performance Excellence Program
Serves as a change agent to re-structure or improve hospital clinical or operational monitoring activities to reflect the philosophy of the evidence based medicine/disease management/clinical programs initiatives.
Assumes implementation responsibilities for change activities required to re-engineer hospital clinical processes to address resource consumption issues.
Educates Medical Staff and hospital administrative staff concerning current trends in cost/resource management.
Identifies clinical topics for review and analysis by medical staff monitoring committees, based on consistent monitoring of clinical practice patterns, feedback from clinicians and physicians and retrospective data analyses of quality, resource consumption and cost reports at a DRG and physician-specific level.
Develops an active, collaborative, interface and structure with Florida Hospital Medical Staff
Organizes process improvement/resource consumption committees on a clinical or product line basis to address quality/resource consumption opportunities. Provides staff support services to such committees
Assures that process improvement/resource consumption/utilization management committees receive data as required to perform target/goal setting, benchmarking/comparative analyses and monitoring activities and to formulate their process improvement recommendations
Assures that data documenting the results of patient care processes and variations in clinical practice are collected on a concurrent basis in an effective format
Contributes to the design and development of Care Management programs in coordination with hospital and division leadership.
Supports the successful coordination of care across the continuum of care/service. Maximizes care coordination for the delivery of quality and efficient care (right care, right time, right place).
Assures a patient-centered approach to the delivery of care/service including support of a holistic patient-care experience supporting the provision of the most appropriate care for each patient.
Creates and sustains collaborative relationships and teamwork across professional disciplines, service lines, departments, etc. to support seamless integration of CM within hospital operations.
Directs utilization management functions including precertification, concurrent review, etc. in support of efficient operations.
Oversees and maintains accountability for compliance with all regulatory standards and requirements
Provides report card of key metrics to administration.
Seizes opportunities to resolve/improve processes.
Ensures interdepartmental collaboration, customer services, and positive working environment with physician advisors.
Ensures regulatory compliance and monitoring of key systems, including review and actions towards key performance management indicators related to strategic imperatives of entire system.
Maintains and regularly updates hospital's case management/utilization review plans and strategies to address identified issues.
Actively develops professional working relationships with community-based continuum resources and with clinical/medical directors of managed care companies.
Develops relationships with, and meets regularly with medical staff leadership, high-volume physicians, and other physicians (as identified) to address resource consumption/utilization issues.
Assures that policies and procedures are reflective of current practice for all direct report departments or areas
Demonstrates ethical behavior in decision making and the performance of job responsibilities.
If you want to be a part of a team that is dedicated to delivering the highest quality in patient care, we invite you to explore the Senior Director – Care Management opportunity with Florida Hospital Lakeview Plaza and apply online today.
Director, Care manager, Maitland, Orlando, Senior Director, RN, Registered Nurse, Nursing Director, case manager, utilization review.
Florida Hospital is dedicated to improving lives not only in Central Florida, but also around the world. As a destination hospital, we are committed to serving the health care needs of our patients with a holistic approach to ...heal the mind, body and spirit. We strive to be the hospital of choice for patients, physicians and employees. Over the last 100 years, Florida Hospital’s mission remains unchanged: to extend the healing ministry of Christ.