The Director of Care Management is responsible for the overall direction and performance of the department of Care Management with USA Health. The director is responsible for ensuring appropriate discharge planning occurs and that resources are utilized efficiently. This position is also responsible for managing care management staff, including performance evaluations as well as overall development and design of care management staffing plans. Candidates should have experience across the continuum of care, and should be experts in the field of case management.
Essential Job Functions
Holds 24-hour accountability for the operation of the department of Care Management
Utilizes all available resources to assure effective performance of the department
Provides appropriate staffing levels and skill mix to support departmental functions
Performs personnel functions for the department to include recruitment, hiring, disciplinary actions, evaluations, counseling and education and follows university and hospital policies related to personnel functions
Documents all personnel actions appropriately
Supports all personnel as valuable assets to the institution
Develops an annual budget that meets the departmental needs within the framework of available resources
Coordinates with other department heads for effective resource use, monitors budgetary expenses and revenues, identifies variances and adjusts spending accordingly
Utilizes cost effective practices in performing all aspects of the job
Evaluates and recommends space allocation and design for the needs of the department
Develops, implements and updates policies and procedures in a collaborative and interdepartmental process according to JCAHO and hospital standards
Prepares and reviews bids, systems of acquisition, distribution and use of supplies, materials and equipment
Supports the mission of the University of South Alabama by translating and incorporating institutional mission, vision and values to staff and others
Provides an environment that is supportive of medical, nursing and allied health students
Performs all duties in a professional and timely manner
Utilizes a computer and appropriate software to generate reports and correspondence both written and electronic
Abides by and enforces all compliance requirements and policies and performs these responsibilities in an ethical manner consistent with the organization’s values
Facilitates staff participation in in-services and educational offerings to learn new skills and for continued development
Assures personnel are competent to carry out their essential functions and that competency skills are completed annually
Monitors work performance of staff
Completes staff evaluations in a timely manner according to policy
Develops a plan of action for employees who are below satisfactory in their evaluation and completes re-evaluation in the appropriate time frame
Participates in the strategic planning activities for the department and institution
Develops a strategic plan for the department that supports the institution’s overall plan
Translates the department or institution strategic plan to staff, ensuring support of the plan, and modifying the plan in response to changing internal and external factors
Assumes accountability for current standards established by professions, regulatory and governmental agencies
Determines, translates, and implements relevant standards and promotes department compliance
Maintains standards of practice consistent with current research findings
Adheres to current Infection Control and Safety Standards
Facilitates cooperative and collaborative relationships among disciplines/departments to assure effective delivery of services to support quality patient care
Encourages and participates in planning and program development to facilitate the effective delivery of services that support quality patient care
Communicates and uses appropriate customer relation skills with physicians, patients, families and healthcare team in person and via telephone
Responds to overhead pages and beeper in a timely manner
Develops and maintains a performance improvement program for the department utilizing the ICARE methodology
Performs those functions for which they are licensed
Manages the Care Management/Social Worker programs promoting high quality, cost effective, compassionate team approach in all patient care matters
Manages the utilization review process, providing guidance and information to the team members including the medical staff, administration and other members of the healthcare team as needed
Communicates with 3rd party payers on specific utilization and discharge planning issues
Ensures that discharge planning is initiated on admission to the hospital including but not limited to placement post hospital, equipment needs, and follow-up appointments
Assures that Medicare, Medicaid and other insurance regulations and revisions arc communicated to care managers, social workers, administration, physicians and to any other healthcare team members that need to know
Participates actively in ensuring that overall compliance with regulatory and accreditation agency standards of care are met
Identifies potential risk management of quality-of-care issues and resolves them through intervention or referral to the attending physician, Ethics Committee, Risk Management or Legal Services as appropriate
Provides documentation as requested of continued services and informs physician when patients in their services no longer meet this criteria
Provides leadership in Utilization Review, Social Worker programs, and MIC/RAC Audits
Demonstrates regular and prompt attendance
Ability to work schedule as defined and additional hours as required
Related duties as required
Bachelor’s degree in nursing or health related field
Four years quality management/utilization review or directly related hospital experience, two years of which must have been in a managerial or supervisory capacity
8-10 years preferred
Applicable licensure with the state of Alabama
About University of South Alabama Health
USA Health is the most comprehensive healthcare organization on the Alabama Gulf Coast. As an academic health system, USA Health provides advanced and innovative patient care through its University hospitals and clinics, as well as first-class training experiences for the next generation of healthcare providers and scientists. In doing so, USA Health has a significant positive impact on the quality of life for all residents across the Gulf Coast.
Care and Treatment
USA Health University Hospital is on the front line in delivering nationally recognized quality care to the area’s most critically ill patients, with the region’s only Level I trauma center and a burn center that provides care from injury to recovery. The life-saving care that stroke and heart patients receive has been recognized year after year by the American Heart Association. University Hospital also plays a key role in the education of tomorrow’s healthcare professionals, each year training hundreds of future professionals from the colleges of Medicine, Nursing and Allied Health Professions.
USA Children’s & Women’s Hospital, among a handful of freestanding hospitals in the United States devoted exclusively... to the care of children and women, offers the region’s most advanced neonatal intensive care and pediatric intensive care units. Providers at Children’s & Women’s Hospital deliver nearly 3,000 babies each year and specialize in high-risk OB/GYN patients. Hospital staff offer a variety of innovative programs for hospitalized children, teens and their families to meet their developmental, educational, social and emotional needs.
Combining cutting-edge research with advanced care, the USA Mitchell Cancer Institute fights cancer from the laboratory bench to the patient’s bedside. With more than 40 clinical trials and 50,000 annual patient visits, MCI is the only academic-based cancer research and treatment facility on the Gulf Coast. In July 2017, MCI opened the Kilborn Clinic in nearby Fairhope, an 11,000-square-foot space that includes exam rooms, cancer treatment areas and physicians’ offices.
USA Health Physicians Group is composed of nearly 250 physicians and 80 advanced practice providers who conduct more than 190,000 patient visits each year. The physicians group is the region’s largest multispecialty practice and the only academic physicians group on the Gulf Coast. Physicians are on faculty at the USA College of Medicine, and the majority of USA Health clinics are located in midtown Mobile at the Strada Patient Care Center, which houses clinics for pediatrics, neurosciences, surgical specialties, obstetrics & gynecology, orthopaedics and therapy services, as well as a breast and mammography center.
In recent years, USA Health has extended its availability to people in the Gulf Coast region through collaborations with local community physicians. This growing effort enables more people to benefit from the region’s only academic medical center.
The on-campus Student Health Center is staffed by physicians, nurse practitioners, registered nurses and licensed practical nurses dedicated to providing quality medical and educational services to the entire student body.
Residents of the Gulf Coast are healthier thanks to the USA College of Medicine. During its history, the college has supplied one-third of the physicians in the Mobile area. The only academic health center along the Gulf Coast, the college enrolls 74 medical students each year, selected from more than 1,100 applicants, and provides graduate medical education training to more than 240 residents and fellows. A doctoral program in basic medical sciences can open doors to academic careers in universities or medical institutions, or to research or administrative positions in government, non-profit or industry settings.