Director Of Care Coordination And Complex Care Management

Overview

LOCATION: John H. Stroger Hospital

DEPARTMENT: Managed Care
- County Care

SHIFT: 9:00am - 5:00pm

SALARY: $159,332 - $181,527

The final salary and offer components are subject to additional approvals based on Cook County Health (CCH) policy. Your placement within the salary range is dependent on a number of factors including your work experience and internal equity within this position classification at CCH.

Job Title: Director of Care Coordination and Complex Care Management

Department: Health Plan Services

This position is exempt from Career Service under the CCH Personnel Rules.

The Director of Care Coordination and Complex Care Management is responsible for the planning, organization, staffing and implementation of Care Coordination and Complex Care Management Services for Health Plan enrolled populations. Leads and inspires a team of clinical and non-clinical staff to support health plan members of all risk levels and needs. This position will be responsible for supporting the achievement of service and quality goals required by regulatory and accreditation organizations.

Oversees the day-to-day care coordination activities to ensure contractual requirements are met, compliant, and of high quality. Assures the appropriateness and effectiveness of care coordination.

• Review applicable Collective Bargaining Agreements and consult with Labor Relations to generate management proposals
• Participate in collective bargaining negotiations, caucus discussions and working meetings
• Document, recommend and effectuate discipline at all levels
• Work closely with labor relations and/or labor counsel to effectuate and enforce applicable Collective Bargaining Agreements
• Initiate, authorize and complete disciplinary action pursuant to CCH system rules, policies, procedures and provision of applicable collective bargaining agreements
• Direct and effectuate CCH management policies and practices
• Access and proficiently navigate CCH records system to obtain and review information necessary to execute provisions of applicable collective bargaining agreements
• Contribute to the management of CCH staff and CCH's systemic development and success
• Discuss and develop CCH system policy and procedure
• Consistently use independent judgment to identify operational staffing issues and needs and perform the following functions as necessary; hire, transfer, suspend, layoff, recall, promote, discharge, assign, direct or discipline employees pursuant to applicable Collective Bargaining Agreements
• Work with Labor Relations to discern past practice when necessary
• Determine approaches to excel in performance, set goals, create and implement action plans and evaluate outcomes
• Provide oversight for the care coordination program development and design; measure outcomes to ensure they meet all contractual requirements and accreditation standards
• Manage the program to achieve outcomes within budgetary parameters and available resources
• Participate in audit processes ranging from lead to participant; monitor and support the Manager of Complex Care Coordination
• Monitor compliance with regulations including State and Federal guidelines
• Support achievement of milestones and targets for care coordination as outlined in the organization's strategic plan
• Ensure meaningful use of data sources to support decision making, program planning and care coordination evaluation
• Identify and implement best practices through expert panels, literature, and external audits
• Work to achieve and/or maintain NCQA accreditation for Cook County Health care coordination activities
• Prepare annual summary of program achievements and plans for the upcoming year
• Develop policies and workflows to adhere to regulatory and program requirements and ensure health, safety and welfare
• Develop onboarding and ongoing training strategies to develop staff skills and achieve program goals
• Oversee an effective field-based model of care coordination that meets standards of care
• Support problem solving and dispute resolution
• Design, analyze, and present reports to facilitate effective operations
• Support managed care organization contractual requirements such as care gap closures and transitions of care for active cases
• Represent the Health Plan and CCH to external entities; collaborate with leadership and provider groups
• Performs other duties as assigned

• Licensed as a Registered Professional Nurse, Licensed Clinical Social Worker, Licensed Social Worker, Licensed Clinical Professional Counselor or Licensed Professional Counselor (must provide proof at time of interview)
• Master's degree in Nursing, Public Health, Business Administration, or Health Care focus from an accredited college or university (must provide official transcripts at time of interview)
• Five (5) years of management work experience (required)
• Two (2) years of care coordination experience in a managed care plan or for a managed care population (required)
• Position may require moderate travel;…