Director, Care Management

Minimum Qualifications:

• MD or RN-BSN    
• Holder of Texas license or eligibility to apply for a Texas nursing or physician license.
• Certification in Case Management (CCM or ACM) or willingness to pursue certification

• Minimum 10 years of experience in acute care setting.  Medical/Surgical and/or ICU experience preferred. 5-7 years hospital leadership experience in a complex health system managing multiple departments or facilities.  
• Ability to form positive, collaborative relationships with members of the executive team, hospital staff, post-acute providers and payers.
• Knowledge of external requirements that impact the department, such as CMS, The Joint Commission and other accreditation or regulatory agencies.
• Demonstrated success in being an advocate for change as demonstrated by experience, attitude and leadership beyond that of a senior leadership and management role.
• Knowledge of payer requirements and discharge planning regulations that support the effective development of departmental policies, procedures and standards.
• Demonstrated ability to:  Establish the goals, vision, and overall direction of a department; create and implement departmental standards, systems, staffing plan and processes; analyze issues and create and effectively plan to address them; critically and comprehensively evaluate the department’s outcomes; identify, collect and analyze data related to the internal and external environment as well as departmental functioning; and, develop and educate staff.
• Proven successful track record with hospital finances, financial systems, budgeting, and capital planning.  Advanced analytical/problem-solving skills necessary to develop and administer an innovative care delivery system, develop overall policy and procedures for division and organization, analyze and evaluate patient care, and plan staffing levels.
• Demonstrated ability to work within a data driven organization, particularly with respect to evidence-based practice.
• Managerial skills necessary to plan, organize, direct and control the operation of a large and critical division and effectively delegate such managerial responsibilities to qualified directors, managers and staff.

Preferred Qualifications:

• Master’s Degree in Healthcare Administration, Business Administration, Nursing or other related field.
• Specific experience in managing Care Management in acute care settings to include care coordination, utilization management, transition planning, and social work.
• Managed care claims/reimbursement experience.
• Demonstrated leadership experience that has included accountability for the design and effectiveness of care improvement, care processes, and/or transitions in care.

Equal Employment Opportunity:

UTMB Health strives to provide equal opportunity employment without regard to race, color, religion, age, national origin, sex, gender, sexual orientation, gender identity/expression, genetic information, disability, veteran status, or any other basis protected by institutional policy or by federal, state or local laws unless such distinction is required by law. As a VEVRAA Federal Contractor, UTMB Health takes affirmative action to hire and advance women, minorities, protected veterans and individuals with disabilities.