Director Care Transitions

About This Role

Direct and oversee the daily operations of care transition functions at Texas Health Southwest, develop strategies to improve outcomes, and manage a team of Care Transition Managers. This role involves significant leadership, policy development, and participation in strategic planning to ensure best-in-class performance in patient care transitions.

Responsibilities

• Oversee the effective daily operation of the care transition function
• Provide and implement strategies to improve operations and outcomes in care transition management
• Direct the activities of Care Transition Managers (RN & SW)
• Serve as a content expert on compliance, mitigation activities, denial management, medical necessity, and psychosocial issues related to transition planning
• Develop and oversee the implementation of policies, procedures, and standards for care transition management
• Participate in the development of new staffing and care designs to support system goals and achieve best-in-class performance
• Analyze clinical and financial data (e.g., LOS, avoidable days, denials) and make recommendations for performance improvement
• Achieve and maintain high levels of internal and external customer satisfaction, collaborating with clinical and interdisciplinary teams
• Develop and manage the operating budget for the care transition function
• Oversee the effectiveness of department recruitment and retention programs and mentor staff development

Requirements

• Bachelor's Degree in Nursing OR Master's Degree in Social Work
• 5+ years directly related experience in hospital case management, including supervisory/leadership experience
• Registered Nurse (RN) OR Licensed Master Social Worker (LMSW) OR Licensed Clinical Social Worker (LCSW)
• CPR certification
• Knowledge of industry standards related to Joint Commission, CMS, OSHA
• Knowledge of managed care contracting, medical necessity, and precertification experience with transition issues
• Knowledge of home health, skilled nursing, and rehabilitation settings related to care coordination
• Ability to analyze and manage information
• Excellent verbal/presentation and written communication skills
• Ability to supervise a diverse and independent staff
• Self-directed and goal/outcomes/measurement driven
• Proficient in Microsoft Office suite

Qualifications

• Bachelor's Degree in Nursing or Master's Degree in Social Work
• 5+ years directly related experience in hospital case management, demonstrating progressive developmental and management growth including supervisory and leadership experience

Nice to Have

• Master's Degree (preferred)
• Accredited Case Manager (ACM)
• Certified Case Manager (CCM)
• Certified Professional Utilization Manager (CPUM)
• ANCC certification
• Knowledge of continuous improvement tools and techniques (Six Sigma, Lean, Clinical Microsystems)
• Experience with electronic health record and automated case management systems

Skills

* Required skills

Benefits

Certifications