Medical Director, Utilization Management, Clinical Documentation Integrity, and Care Coordination

Mary Washington Healthcare; Fredericksburg (VA); On-site; USD 293,000 - 358,000; Full time

Job summary

Mary Washington Healthcare in Virginia seeks a Director of Care Coordination to lead the organization-wide Care Coordination Model, drive patient throughput improvements, and manage resources to support the strategic plan at Mary Washington and Stafford hospitals.

You will supervise care coordination staff, collaborate with leaders, implement SOPs and care logistics systems, and monitor outcomes and quality measures to ensure efficient patient progression and compliance with regulations.

Qualifications

• Registered Nurse with Bachelor's degree in Nursing or Social Worker with Master's degree in Social Work/Health-related field and at least 5 years hospital work experience.
• Minimum 5 years of healthcare management experience.
• Strong communication and interpersonal skills to work with nursing colleagues, physicians, administrators, and the healthcare team.
• Ability to develop productive relationships with other leaders.
• Ability to teach/educate and motivate others.
• Ability to form strong team bonds and enhance team performance.
• Strong organizational and quality management skills; able to handle multiple tasks.
• Experience with Windows-based programs, email, and Microsoft Word.

Responsibilities

• Directs all aspects of the Care Coordination Model to improve length of stay and patient throughput.
• Collaborates with leaders to implement SOPs and Care Logistics systems.
• Educates medical staff on placement, resources, pre-certifications, payer requirements, and regulations.
• Ensures plans comply with policies, standards of care, and budget.
• Supports continuous performance improvement and metrics tracking.
• Leads deployment of Operational Rounding Program and aligns critical outcomes.
• Participates in policy development and care coordination procedures.
• Interviews and develops Care Coordination staff and staffing guidelines.
• Other duties as assigned.

Skills

Communication

Interpersonal skills

Leadership

Staff development

Team building

Organizational skills

Quality management

Change management

Technology proficiency

Education

Bachelor's degree in Nursing

Master's degree in Social Work/Health-related field

Tools

Windows

Microsoft Word

Email

Job description

Start the day excited to make a difference...end the day knowing you did. Come join our team.

Job Summary:

The Director of Care Coordination is responsible for directing and supporting the organization-wide Care Coordination Model to drive improvements in patient throughput performance and overall hospital length of stay for Mary Washington and Stafford hospitals. The Director of Care Coordination assumes operational responsibility for the overall management of human, fiscal, and material resources as well as the integration of the Care Coordination Department as it relates to the strategic plan of the organization.

Annual base salary range: $325,000 (min) - $325,000 (max)

Essential Functions & Responsibilities:

• Directs all aspects (planning, priority setting, coordination, implementation, and evaluation) of the Care Coordination Model to improve length of stay performance and patient throughput of the organization, to include the following: Throughput and Patient Placement, Care Management for Patient Progression and Revenue Cycle, Care Coordination Center Operations and Leadership, and Organizational Metrics/Measures of Success
• Collaborates with corporate, hospital, and department leaders to implement Care Coordination Model roles, standard operating procedures (SOPs), Care Logistics operating system software, SNAP and Escalation Huddles, and Operational Rounding Program.
• Consults, coordinates, and educates the medical staff and healthcare team on issues of appropriate placement, utilization of resources, pre-certification and payer requirements, government regulations and appropriate levels of care.
• Ensures patient care coordination plans and activities comply with established policies and procedures, standards of care, regulatory requirements, budgetary parameters, and strategic objectives.
• Supports and fosters a commitment to continuous performance improvement by providing a coordinated system for evaluating patient care outcomes, quality measures, and key performance measures.
• Serves as throughput and efficiency Deployment Leader for Operational Rounding Program; creates and supports Executive Plan (A3) and identifies/aligns on critical outcomes for the organization and leading processes to drive outcomes.
• Participates in the development, review, and revision of policies and procedures consistent with the institutional practice and Care Coordination Model
• Interviews, hires, develops, counsels, and evaluates Clinical Care Coordination staff to maintain highly competent, mission-oriented, and values-driven team.
• Develops staffing guidelines that support Care Coordination Model, current budget, and external benchmarks
• Other duties as assigned

Qualifications

Required:

• Registered Nurse with Bachelor's degree in Nursing and a minimum of 5 years clinical nursing experience OR Social Worker with Master's degree in Social Work/Health-related field with a minimum of 5 years hospital work experience
• Minimum 5 years of healthcare management experience
• Able to demonstrate strong communication and interpersonal skills with ability to work effectively and collaboratively with nursing colleagues, physicians, administrators, and the entire healthcare team.
• Able to develop strong and productive working relationships with other leaders
• Able to teach/educate and motivate others
• Able to form strong team bonds and enhance team performance
• Strong organizational and quality management skills with ability to handle multiple, competing tasks and priorities
• Able to cope with rapidly changing information in a fast-paced environment
• Experience with computer technology, specifically experience with Windows based programs, e-mail, and Microsoft Word.

Preferred:

• For RNs - Master's degree in nursing/health-related field preferred
• Professional Nursing Leadership Certification (ANCC or AONL), or content expert certification preferred.

License and/or Certifications

Required:

• For RNs - Registered Nurse licensed to practice in the Commonwealth of Virginia
• For Social Workers - Licensed Social Worker licensed to practice in the Commonwealth of Virginia.

MWHC will not discriminate in its employment practices due to an applicant's race, color, religion, sex, sexual orientation, gender identity, national origin, and veteran or disability status (EOE). We are also committed to equitable and transparent compensation practices and comply with all applicable pay transparency and pay equity laws.

Compensation Pay Range: