Director of Care Management- Quality Assurance and Quality Improvement

PRIMARY DUTIES 

• Lead and direct all care management activities, ensuring patient care coordination and adherence to clinical protocols and regulatory standards. 

• Develop and implement care management programs, standing delegated orders, transitions of care, management protocols, policies, and departmental strategy in consultation with senior leadership. 

• Supervise a multidisciplinary team of care managers responsible for patient care coordination. 

• Develop and maintain a tracking system for seamless care coordination across medical services, including transitions and referrals. 

• Utilize CM tracking to meet productivity targets. 

• Collaborate with the Director of Population Health to address quality and clinical priorities. 

• Develop and oversee quality management and improvement programs in collaboration with various clinical Chief Officers. 

• Conduct data analysis and reporting 

• Perform internal audits to ensure compliance with organizational and state/federal practices, policies, and regulations. 

• Manage departmental budget and staffing. 

• Lead regular Care Team meetings and departmental meetings. 

OTHER DUTIES 

• As assigned by supervisor 

PHYSICAL AND MENTAL REQUIREMENTS 

• Possess a valid Texas driver’s license and appropriate liability insurance 

• Access to personal transportation 

• Visual and auditory accuracy 

• Shift length varies 

• Indoor setting 

• Continuous use of computer 

• Long periods of sitting 

• Frequent use of telephone and/or smart devices 

• Continuous repetitive grasping and manipulation of both hands 

• Continuous conversational communication 

• Occasional reaching, walking, squatting, bending, kneeling, twisting and climbing 

• Occasionally carrying, lifting, pushing and pulling of up to 25 lbs. 

• Occasionally working in confined, noisy, dusty areas 

• Understand/carry out simple/detailed, oral/written instructions 

• Memorize and retain instructions 

• Read and interpret detailed specifications 

• Mental competency 

• Tobacco non-user 

• Physical accommodations will be implemented where necessary and feasible 

REPORTS TO: Chief Nursing Officer and Chief Clinical Officer 

EDUCATION & EXPERIENCE 

• Required 

• Bachelor’s degree in a related field 

• Certifications: RN 

• Two years of case/care management experience 

• Preferred 

• Outpatient case/care management experience 

• Prior managerial experience in a healthcare setting 

• Certified Case Manager (CCM) designation 

• Certification in Healthcare Quality 

• Quality assurance / quality improvement oversight experience 

SKILLS 

• Departmental leadership skills 

• Ability to teach and supervise care management, disease management, and patient education skills. 

• Ability to teach knowledge of chronic physical and behavioral health conditions. 

• Ability to teach evidence-based behavioral strategies, including motivational interviewing. 

• Strong interpersonal skills with the ability to build effective relationships across medical teams and with patients. 

• High proficiency in problem identification and care plan development. 

• Professional interaction skills with medical providers and other healthcare professionals. 

• Skillfully conduct health assessments and screenings. 

• Ability to perform the duties of Social Work and Nurse Care Managers 

• Knowledge of quality assurance and quality improvement processes 

• Strong written and oral communication skills.