The Manager of Care Coordination is responsible for the support and direction of the care coordination and community health worker programs including staffing, standards, systems, policies, procedures and monitoring progress toward achieving metrics and goals in alignment with organizational strategic initiatives. Specifically, this position assists in efforts to optimize care coordination across the care continuum in accordance with the strategic plans and mission of the hospital system. The functions that report to this Manager: care coordination and community health workers supporting both Nemours and DCHN primary care practices. This position is responsible for the daily operation of care coordination functions through oversight of both daily and long term activities. The Manager is accountable for achieving established performance targets through actively engaging multiple disciplines and professional staff, both within the health system and in the community.

The Manager assists with the development and execution of processes and procedures to establish and promote compliance, satisfaction, quality and performance standards. Dashboard development, monitoring and reporting to medical management leadership regarding program operations on an ongoing basis will be required. Program design and implementation will need to consider and actively interface with and leverage existing PCMH, Care Management, practice level care navigation, wellness and facility case management programs.

Essential Functions-

• Work collaboratively with medical management and VBSO leadership to achieve and sustain best practices and staffing targets to support care coordination activities across the continuum for the populations served.
• Manages the development, implementation and standardization of centralized care coordination and disease management infrastructure, policies, procedures and programs in conjunction with related goals and objectives.
• Ensures compliance with federal and state regulations, understands and ensures that the program, policies and processes meet the delegating health plan delegation requirements, while ensuring compliance with organizational policies and procedures. Uses, protects and discloses protected health information (PHI) only in accordance with Health Insurance Portability and Accountability Act (HIPAA) standards.
• Fosters integration and strong clinical partnerships with hospitalists, physician advisors, local physician leadership and clinical integration activities in order to optimize care coordination across the care continuum, ensure efficient resource utilization, improve quality outcomes and enhance patient satisfaction. This includes partnerships within the Hospital system and throughout the state where impacted population reside and/or where needed providers are located.
• Facilitates a team process problem solving approach utilizing the Hospital/Health system resources across the care continuum.
• Collaborates with community providers to develop and support access for patients and performance improvement.
• In conjunction with the Senior Director, establishes quality and performance standards, and analyzes quality assessment and improvement data to determine the effectiveness of programs for presentation to executive leadership on an ongoing basis.
• Collaborates with the Senior Director to develop action plans to address areas needing improvement and methods to track variances for the care and services delivered.
• Prepares for, attends and participates in all assigned committees and task forces.
• Closely monitors and analyzes, using statistical methods, to assess, establish and evaluate trends and educational needs among the care coordination staff. Develops and executes solutions to improve outcomes and resource management, including new care coordination approaches. Participates in and organizes ongoing educational services for staff and providers, including comprehensive orientation programs, cross training and proactive care management processes.

Qualifications-

Bachelor's Degree

Licensed registered nurse (active and unrestricted in the State of Delaware and Pennsylvania)

• Minimum of three (3) years of supervisory experience
• Minimum of five (5) years clinical experience, preferably with pediatric populations
• General Management Software Tools
• Case Management tools and systems
• Microsoft Office Suite, spreadsheet experience a plus