Senior Director Case Management

Sr Director Case Management

At Houston Methodist, the Sr Director Case Management position is responsible for providing executive leadership and strategic oversight for all hospital-based Case Management Directors and the Central Utilization Review Director across the system. This position is responsible for the integration and advancement of a unified case management model grounded in clinical excellence, throughput efficiency, care transitions, and denials prevention. A champion of a progressive care management model, the Sr Director Case Management position promotes innovative strategies while fostering interprofessional collaboration across clinical and administrative domains. This position leads enterprise-wide initiatives aimed at optimizing patient progression of care, aligning utilization review practices, enhancing discharge planning processes, and strengthening compliance with CMS Conditions of Participation. The Sr Director Case Management position will interface with system leadership, medical staff, physician advisors, population health, revenue cycle, and post-acute networks to ensure high-performance outcomes, efficient use of resources, and superior patient experiences. The Sr Director position has a direct report to a VP level or above and directs work that has a significant impact on the organization and strategic goals. This position leads or directs key programs; large scope (i.e., system-wide, TMC, or all community hospitals). The scope for the Sr Director position involves setting the strategic vision and administration and has responsibility for multiple budgets (operational and capital) and / or directs work that has significant financial implications, including high-level oversight of the activities within the assigned functional area(s), ensuring quality, productivity, functional excellence, and efficiency to accomplish strategic and operational objectives. In addition, the Sr Director position is accountable for employee engagement, adequate staffing levels, budget development and compliance, and developing and implementing policies and procedures to ensure a safe and effective work environment. This position also ensures training, monitoring and operations initiatives are implemented which secure compliance with ethical and legal business practices and accreditation / regulatory / government regulations. The Sr Director position may serve in lieu of an entity director for the assigned functional area(s). This position may also have direct reports to include director-level employees.

PEOPLE ESSENTIAL FUNCTIONS

• Sets the strategic vision and administration and is responsible for multiple budgets (operational and capital) and / or directs work that has significant financial implications including high-level oversight of the activities within the assigned functional area(s), ensuring quality, productivity, functional excellence, and efficiency to accomplish strategic and operational objectives.
• Directs, develops, and implements strategic and operational / high-level projects and processes through independent / highly autonomous work or through the facilitation of work teams to enable the effective and efficient completion of objectives.
• Oversees and ensures development for staff to meet overall objectives in terms of quality, service, and cost-effectiveness. Provides timely guidance and feedback to help others strengthen specific knowledge / skill areas needed to accomplish a task or solve a problem. Provides a functional area oversight guidance and directs management responsibilities of selection, scheduling, supervision, retention, and evaluation of employees.
• Reviews metrics for the function on a holistic basis. Meets or exceeds threshold goal for department turnover and / or system metrics on employee engagement indicators.
• Provides leadership and communication to maintain a competent and engaged employee group by conducting function leadership meetings to review policies and procedures and operational matters, rounding on all direct reports, completing performance appraisals, conducting new hire feedback sessions, coaching / corrective counseling, and providing recognition / commendations to achieve desired outcomes. Ensures information pertinent to function operations cascades appropriately to each entity.
• Identifies opportunities and takes action to build strategic relationships between one's functional area and other areas, teams, departments, and units to achieve business goals. Drives the promotion of teamwork within and between entities and departments; participates and / or leads system function process improvements as needed.
• Collaborates with HMCPA on care transition and utilization management initiatives.
• Provides strategic vision and execution for case management and utilization review across all hospitals and central departments. Establishes clear expectations for leadership performance, operational benchmarks, and accountability frameworks for hospital CM Directors and Central UR Director.

SERVICE ESSENTIAL FUNCTIONS

QUALITY / SAFETY ESSENTIAL FUNCTIONS

FINANCE ESSENTIAL FUNCTIONS

GROWTH / INNOVATION ESSENTIAL FUNCTIONS

This job description is not intended to be all-inclusive; the employee will also perform other reasonably related business / job duties as assigned. Houston Methodist reserves the right to revise job duties and responsibilities as the need arises.

EDUCATION