CommonSpirit Health was formed by the alignment of Catholic Health Initiatives (CHI) and Dignity Health. With more than 700 care sites across the U.S., from clinics and hospitals to home-based care and virtual care services, CommonSpirit is accessible to nearly one out of every four U.S. residents. Our world needs compassion like never before. Our communities need caring and our families need protection. With our combined resources, CommonSpirit is committed to building healthy communities, advocating for those who are poor and vulnerable, and innovating how and where healing can happen, both inside our hospitals and out in the community.
Responsible for the establishment and continued development of System Case Management Model including Case Managers and Social Workers strategy and approach utilizing standardized operational processes. Utilizing a matrix reporting model, this position collaborates with Facility CFOs to provide direction/resources to the facility Case Management Director/Manager. Responsible for the administration and implementation of technical and Health System standardized processes as well as ensuring the implementation and governance of all Case Management Health System policies and procedures. Acts as a liaison between System leadership and facility-level Case Management, and is primarily responsible for ensuring each hospital has effective processes, policies, and procedures for ensuring patient care is integrated between payors and providers, thus resulting in cost-effective, quality care with a focus on utilization management. This position standardizes processes where possible; ensures hospital level accountability, efficiency and productivity; and institutes and maintains Case Management best practices across the System. Actively participates in the coordination and reporting of quality enhancement activities and cost-related projects and outcomes. Actively involved in evidenced-based practice activities for both clinical and system redesign with the goal of enhancing quality and financial outcomes. Ensures up-to-date knowledge permeates Facility Case Management departments. Also responsible for providing strategic direction and leadership for the clinical documentation and quality improvement function within each local care delivery market and throughout the System. Accountable for leading the development and implementation of national standards for Clinical Documentation and Improvement Plan.
Education and Licensure Required:
*Registered Nurse (RN)
*Seven (7) years related experience in the discipline and five (5) years leadership experience
Minimum Knowledge, Skills, and Abilities:
* In-depth knowledge of CMS regulations in both the inpatient and outpatient arenas is required
* Excellent written and verbal communication skills
* Broad-based knowledge regarding clinical practice, insurance and legal disciplines, hospital operations, and revenue cycle.
* Expert in problem resolution techniques.
* Excellent analytical skills, including data aggregation, analysis, interpretation, and application are required
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