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, driving improvements in patient throughput and hospital length of stay at Mary Washington and Stafford hospitals. You will oversee resources and integrate the department with the organization's strategic plan.

Key duties include directing all aspects of the Care Coordination Model, collaborating with leaders on SOPs and tools, educating staff on placement and payer

Qualifications

• Registered Nurse with a Bachelor’s degree in Nursing and a VA license OR Social Worker with a Master’s degree and VA license.
• Minimum 5 years healthcare management experience.
• Strong communication and interpersonal skills with the ability to work with nursing staff, physicians, admins, and the health team.
• Able to develop productive working relationships with other leaders.
• Able to educate and motivate others; build strong team performance.

Responsibilities

• Directs all aspects of the Care Coordination Model to improve length of stay and throughput.
• Collaborates with leaders to implement SOPs, care logistics tools, and escalation processes.
• Educates staff on placement, resource utilization, pre-certification, payer requirements, and regulatory rules.
• Ensures care coordination plans comply with policies, standards, budget, and strategic goals.
• Supports continuous improvement by evaluating outcomes and key metrics.
• Leads staffing guidelines to support the Care Coordination Model and budget.

Skills

Communication skills

Interpersonal skills

Leadership

Staff development

Team collaboration

Organizational skills

Quality management

Education

Bachelor’s degree in Nursing

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

Job description

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: Working at Mary Washington Healthcare

As a Great Place to Work-Certified company we treat our Associates like family – with respect, understanding, and communication. Safety is our top priority As a healthcare system, patient and Associate safety is our priority which is why all Associates will be required to take the following vaccines*: Annual flu vaccine *MWHC reserves the right to amend this list at any time. Medical and Religious exemptions may apply,. Will be discussed at interview.