HealthPartners has an exciting opportunity for a Director of Care Integration. This Director of Care Integration creates the strategy for overall transitions of care for Methodist Hospital in St. Louis Park from the acute care setting to home, or post-acute care. This individual has accountability for collaborating on strategies and tactics across the HealthPartners system of care. In addition, primary responsibility for decreasing inappropriate utilization of health care services on the Methodist Hospital campus, including the Emergency Center and the hospital is part of this role. The Director of Care Integration is responsible for leading and developing best practices related to discharge planning, domestic violence (Advocare program), Utilization Management, and Center for Medicare and Medicaid Services rights. This leader will use the triple aim as the focus for work flow processes: providing high quality care and an exceptional patient experience at an affordable cost. The key processes that are supported by the Care Integration team members include: accurate account type assignment; utilization management; and patient transition planning, both in the Emergency Center and inpatient care units. This individual works closely with a dyad partner and the Physician Advisor, who supports the compliance, documentation, and utilization management aspects of the role.
At HealthPartners, you’ll find a culture where we live our values of excellence, compassion, integrity and most importantly, partnership. By working together, we will improve health and wellbeing, create exceptional experiences for those we serve and make care and coverage more affordable.
1. Develops and directs Care Integration Services to assist patients, families and staff in providing resources relevant to the medical, social, psychological, cultural and financial aspects of health care. Leads and continues to evolve the behavioral health care model social work and registered nurse care planning. In addition, the care integration team collaborates with others to ensure a superior patient experience in all care coordination survey questions and for value-based payment initiatives.
2. Collaborates with medical staff, nursing care team, and leadership team, particularly the inpatient service line and PNHS hospitalist service to ensure a timely discharge from the hospital setting. Facilitates connections across the value stream between departments and ensures warm hand offs for coordinated care. Major stakeholder and leader for post-acute care network strategies.
3. Collaborates with the high risk case management team to identify patients who are at high risk of readmission, and develops a transition plan together with the next care team to ensure patients are able to remain out of the hospital.
4. Creates, analyzes, and improves data analytics related to length of stay, readmissions, utilization, denials and other facets of the department.
5. Ensures care coordination educational programs enhance staff understanding of emotional, cultural, and cost effective care of patients and families and documentation and coding of that care.
6. Leads and participates in cross-organizational committees including the Utilization Review Committee; Readmissions Guidance Committee, and Enterprise Post-Acute Steering Team, and any transitions teams related to core responsibilities of the Care Integration department.
7. Responsible for the AdvoCare Program, RN Care Coordinators, social workers, utilization management, CMS Rights Specialists and Compliant Documentation Improvement Programs.
8. Supervises direct reports, including hiring, orienting, coaching, disciplining, mentoring, and conducting performance reviews.
9. Works in collaboration with other Methodist/PNHS departments to assure the provision of patient and corporate services.
• Communicates with leadership team and Care Integration Services.
• Develops and ensures consistent application of policies and procedures relative to areas including compliance with existing regulatory agencies.
• Designs strategies and goals in collaboration with the leadership team consistent with PNHS’ mission, vision, values and goals.
• Establishes linkages and collaborates across the Park Nicollet system and community to ensure optimal patient discharges.
• Ensures Care Integration Services’ education programs to enhance staff understanding of emotional, cultural, and cost effective care of patients and families, and documentation and coding of that care.
• Attends PNHS’ Emergency Preparedness Committee
• Coordinate Methodist Hospital Utilization Review Committee.
• Develops management tools and measures of productivity for Care Integration Services staff.
• Manages the various computer software programs used by Care Integration Staff and sub-departments.
• Investigates and resolves, as needed, patient concerns regarding quality of services provided by dept.
10. Responsible for operating expense and capital budget for assigned areas.
11. Other duties as assigned
• Current MN Registered Nursing license.
• Master’s degree in a health care field preferred.
• Minimum of five years relevant experience in the field.
• Experience and demonstrated leadership in interdisciplinary teamwork.
• Knowledge of health care budget process and financial management.
• Knowledge of managed care/ACO principles.
• Knowledge of applicable external organization regulations/laws pertaining to work of nursing, social work, DRG reimbursement system, and utilization management.
• Process/clinical improvement methodologies (Lean/ATP)
HealthPartners offers a comprehensive benefits package. To see a complete job description and/or to apply for this position, please visit www.healthpartners.com/careers, click on job opportunities and search for Job ID #50518.
St. Louis Park, MN