Director, Care Management & Social Work New! Rev Cycle Admin | Full-Time | Phoenix ...Read More[...]

Phoenix Children's Hospital, Inc.

Phoenix (AZ)

On-site

USD 180,000 - 280,000

Full time

14 days+

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Benefits offered by this job

None

Job summary

Phoenix Children\'s Hospital, Inc. in Phoenix, AZ seeks a senior leader to direct Care Coordination across the enterprise.

You will guide Inpatient Care Management, Utilization Management and Social Work, align with nursing floor management, and ensure seamless end-to-end patient experience. Lead vendor relationships, implement population health initiatives, and collaborate with stakeholders to improve outcomes while controlling costs.

Qualifications

Bachelor's degree in Nursing. Required
Current credentials in Case Management or Social Work or equivalent experience. Required
Master's degree in Nursing, Management, Organizational Development, or related field. Preferred

Responsibilities

Provides leadership to assigned departments, partners with the VP of Revenue Cycle to develop strategies, implement policies and procedures, and develop KPIs to meet financial and non-financial goals.
Directs, manages and evaluates the effectiveness and efficiency of Social Work, Case Management and Utilization Management by establishing controls and reviewing associated procedures.
Manages day‑to‑day operations ensuring compliance with regulatory and legal requirements and quality standards that meet or exceed community standards of care.
Identifies and manages improvement initiatives, develops clear business and project plans, and implements corrective measures to enhance performance.
Performs organizational and administrative duties, manages the department budget, prepares financial reports, evaluates systems, and oversees vendor relationships.
Demonstrates exceptional customer service, builds teamwork, maintains relationships with patients and care providers, and collaborates with other departments to solve complex interdepartmental issues.
Develops team members through timely feedback, HR policies, and training opportunities to achieve professional growth.
Performs miscellaneous job‑related duties as requested.

Skills

Leadership

Communication

ICD-10 knowledge

InterQual knowledge

Revenue cycles

MCG guidelines

Decision making

Education

Bachelor's degree in Nursing

Current Case Management or Social Work credentials

Master's degree in Nursing/Management/Organizational Development

Tools

Milliman guidelines

Allscripts Care Management

Job description

Position Overview

This position is responsible for the overall leadership, strategic direction and operations oversight of Phoenix Children`s Care Coordination Departments across the enterprise, including Inpatient Care Management, Utilization Management and Social Work. This position is accountable for ensuring coordination of patient information with nursing floor management and ensuring close daily communication, as well as, being responsible for the development and implementation of a comprehensive Care Coordination, specific to Care Management, Utilization Management, and Social Work, designed to ensure the patient/family experience from end-to-end is positive, family-centered, accessible and accurate. This position manages existing Care Coordination vendor relationships, implements and manages a population health program, and collaborates with other key stakeholders to ensure patients are successfully transitioned to Phoenix Children’s Care Navigation programs with the goal of improving clinical outcomes through advocacy, partnership and innovation, while lowering the cost of healthcare.

Position Duties

Provides leadership to assigned departments, partners with the VP of Revenue Cycle to develop strategies, implement policies and procedures, and develop KPIs to meet financial and non-financial goals.
Directs, manages and evaluates the effectiveness and efficiency of Social Work, Case Management and Utilization Management by establishing controls and reviewing associated procedures.
Manages day‑to‑day operations ensuring compliance with regulatory and legal requirements and quality standards that meet or exceed community standards of care.
Identifies and manages improvement initiatives, develops clear business and project plans, and implements corrective measures to enhance performance.
Performs organizational and administrative duties, manages the department budget, prepares financial reports, evaluates systems, and oversees vendor relationships.
Demonstrates exceptional customer service, builds teamwork, maintains relationships with patients and care providers, and collaborates with other departments to solve complex interdepartmental issues.
Develops team members through timely feedback, HR policies, and training opportunities to achieve professional growth.
Performs miscellaneous job‑related duties as requested.

Mission, Vision & Values

Mission: To advance hope, healing and the best healthcare for children and their families.

Vision: Phoenix Children`s will be the leading pediatric health system in the Southwest, nationally recognized for exceptional care, innovative research and advanced medical education.

We realize this vision by:

Offering the most comprehensive care across ages, communities and specialties
Investing in innovative research, including emerging treatments, tools and technologies
Advancing education and training to shape the next generation of clinical leaders
Advocating for the health and well-being of children and families

Values:

We place children and families at the center of all we do
We deliver exceptional care, every day and in every way
We collaborate with colleagues, partners and communities to amplify our impact
We set the standards of pediatric healthcare today, and innovate for the future
We are accountable for making the highest quality care accessible and affordable

Position Qualifications

Education

Bachelor's degree in Nursing. Required
Current credentials in Case Management or Social Work or equivalent experience. Required
Master's degree in Nursing, Management, Organizational Development, or related field. Preferred

Experience

Ten (10) or more years of experience in case management or social work. Required
Five (5) or more years of managerial experience in an acute care hospital. Required
Five (5) or more years leading functions/departments supporting families with hospital resources, community resources, and/or resource/utilization management such as Social Work, Financial Counseling/Eligibility, and/or Case Management. Required
Pediatric experience. Preferred

Special Skills

Working knowledge of ICD-9 and ICD-10 coding, MCG, Interqual, financial clearance, revenue cycles, and reimbursement, decision‑making, leadership, computer skills, and communication. Required
Extensive knowledge of Milliman guidelines and Allscripts Care Management. Preferred

Additional Requirements

Current State of Arizona RN License or an RN License from a compact state with multistate privileges. Required
Valid Arizona Department of Public Safety Fingerprint Clearance Card. Required
Certified Care Manager or Certified Case Manager Certification (CCM). Preferred

Physical Requirements & Occupational Exposure