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Director Care Management CMP

Location: Buffalo, NY, United States
Date Posted: Jul 12, 2019

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Job Description

Status: Full Time Facility: Administrative Regional Training Cntr

Work Schedule: Days Shift: 1:

Exempt from Overtime: Exempt: Yes FTE: 1.000000: Bargaining Unit: ACE Associates

Summary:
The Director Care Management for Catholic Medical Partners (CMP) will be responsible for supporting the Medical Director in the developing and implementing clinical integration programs which include Population Health Management, Care Management, and Utilization Management in alignment with medical policy, evidence based guidelines and NCQA patient centered medical home. The Director Care Management works in close collaboration with the Medical Director on all aspects of physician membership, physician relations and optimization of the network. This position is responsible for implementing the CMP clinical and care management programs around industry best practices to enhance quality of care, lower the cost of care and improve patient safety in alignment with the CMP clinical integration program, accountable care organization and NCQA PCMH standards. Coordinates care management initiatives with Catholic Health (CH).



The Director Care Management is also responsible to carry out the project management requirements supporting the 10 clinical integration initiatives for Delivery System Reform Incentive Program (DSRIP).

Responsibilities:

EDUCATION
  • BSN degree in nursing or MS degree in health care administration

EXPERIENCE
  • A minimum of ten (10) years of relevant work experience in the areas of care coordination, utilization management with a focus on program design, staff education , measurement and continuous improvement

KNOWLEDGE,SKILL AND ABILITY
  • Candidate needs to have demonstrated clinical or administrative leadership
  • Excellent knowledge of how to successfully design and implement care coordination program consistent with NCQA standards and capable of achieving the Triple AIM
  • Strong ability to lead professional team in delivering high quality care management services.
  • Knowledge of best practice guidelines and objective measures of quality care.
  • Strong ability to train care coordinators to deliver high quality disease management in the clinical office.
  • Solid understanding and utilization of current information technology systems designed to support care management, as well as track and trend results.
  • Project management skills with focus on accurate timeline and milestone objectives.
  • Excellent verbal and written interpersonal communication skills.
  • Excellent problem solving skills and knowledge of flow charting to optimize operational reliability.



WORKING CONDITIONS



ENVIRONMENT
  • Normal heat, light space, and safe working environment; typical of most office jobs.



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