Interim Director of Care Coordination- AZ

American Consultants is looking for an Interim Director of Care Coordination at a facility outside of Flagstaff, AZ.

The Director of Care Coordination is the responsible for leading, supervising, managing, and coordinating multiple care coordination/social services departments to include Case Management, Utilization Review, Durable Medical Equipment/Transportation, and Purchased Referred Care. The position directs the departments and is fully accountable for monitoring program activities, including compliance, planning, implementing, and evaluating program development to ensure clinical and financial activities promote the continuum of care and appropriate use of clinical and financial resources. The position is comprised of complex managerial, clinical care coordination and administrative components, associated with critical issues affecting patient care and overall standards of patient care coordination that influence the organizational mission, health care and policy.

The Director of Care Coordination is the clinical and administrative coordinator for all aspects of care coordination including policies and practice, budgetary and administrative oversight of compliance with facility directives. This position provides oversight for the local Care Coordination department to include: administrative staff for review of eligibility, authorizations and scheduling etc., Social Workers for discharge planning and case management, Registered Nurses (RN's) for case management, utilization review, discharge planning, and processes related to review and approval of Purchased Referred Care referral requests (for justification and medical necessity), and/or denial of Purchased Referred Care referrals and/or cases, and denied/appealed care claims based on eligibility criteria.

The goals are to center services around the patient, to foster patient self-managed care, and maximize efficient and cost-effective use of health care resources. The Director of Care Coordination utilizes all avenues of resources available to ensure staff provide safe and efficient timely coordination of quality health care and services. The role of the Director of Care Coordination is to establish, promote and monitor seamless care for patients.

NECESSARY QUALIFICATIONS

Education:

Master’s degree in nursing

License:

A valid, current, full and unrestricted Professional Nursing License to practice nursing in any state of the United States of America, The Commonwealth of Puerto Rico, or a territory of the United States

Experience:

Five (5) years of supervisory experience in discharge planning, case management, or utilization review in an acute-care health care setting or related healthcare clinical leadership

Other Skills and Abilities:

A record of satisfactory performance in all prior and current employment as evidenced by positive employment references from previous and current employers. All employment references must address and indicate success in each one of the following areas:

• Accessing community resources for patient referrals
• Knowledge of diagnosis related groups (DRG) and documentation requirements
• Positive working relationships with others
• Possession of high ethical standards and no history of complaints
• Reliable and dependable; reports to work as scheduled without excessive absences
• Ability to sense varying skill levels and direct instruction accordingly
• Detail oriented, well organized, and applies critical thinking, reasoning, deduction, and inference skills
• Knowledge of report writing, graphical analysis, and working with computer spreadsheets and database programs
• Completion of and above-satisfactory scores on all job interviews, demonstrating to the satisfaction of the interviewees and the facility that the applicant can perform the essential functions of the job
• Successful completion of and positive results from all background and reference checks, including positive employment references from authorized representatives of past and current employers demonstrating to the satisfaction of the facility a record of satisfactory performance and that the applicant can perform the essential functions of the job
• Successful completion of fingerprint clearance requirements, physical examinations, and other screenings indicating that the applicant is qualified to be employed by the facility and demonstrating to the satisfaction of the facility that the applicant can perform the essential functions of the job
• Submission of all required employment-related documents, applications, resumes, references, and other required information free of false, misleading or incomplete information, as determined by the facility

PREFERRED QUALIFICATIONS

Education:

Board Certification with the American Case Management Association (Certified Case Manager) or successful completion with in six (6) months of employment