Job descriptionPosition Summary ORLANDO HEALTH ARNOLD PALMER HOSPITAL FOR CHILDREN Located on the downtown Orlando Health campus, Orlando Health Arnold Palmer Hospital for Children has been providing compassionate care to the children, teenagers and young adults of Central Florida for more than 30 years. With 156 licensed beds and a team of experts in more than 30 pediatric specialties, the hospital has earned a “Best Children’s Hospitals” recognition by U.S. News & World Report for 14 consecutive years and has been named a Top Children’s Hospital by the patient-advocacy Leapfrog Group. Orlando Health Arnold Palmer has held Magnet® Recognition for nursing excellence and quality patient care since 2013 and several units have earned Beacon Awards for Excellence for employing evidence-based practices to improve patient outcomes and patient and staff satisfaction. Our pediatric Level I Trauma Center and ER is the only Central Florida facility to provide the highest level of emergency trauma care exclusively to children, and Orlando Health Arnold Palmer is the only facility in Florida to achieve Level I Children’s Surgical Verification and Level I Trauma Verification by the American College of Surgeons. Orlando Health Arnold Palmer is part of the Orlando Health system of care, which includes award-winning hospitals and ERs, specialty institutes, urgent care centers, primary care practices and outpatient facilities that span Florida’s east to west coasts and beyond. Collectively, our 27,000+ team members honor our over 100-year legacy by providing professional and compassionate care to the patients, families and communities we serve. Orlando Health is committed to providing you with benefits that go beyond the expected, with career-growing FREE education programs and well-being services to support you and your family through every stage of life. We begin your benefits on day one and offer flexibility wherever possible, so that you can be present for your passions. “Orlando Health Is Your Best Place to Work” is not just something we say, it’s our promise to you. Come Join Orlando Health Team! Top Reasons to Choose Orlando Health: Competitive Pay: Evening, nights, and weekend shift differentials offered for qualifying positions. All Inclusive Benefits: Student loan repayment, tuition reimbursement, back up elder and childcare, pet insurance, and more for full time and part time employees. Employee-centric: Orlando Health has been selected as one of the 2020 “Best Places to Work in Healthcare” by Modern Healthcare. Committed to Community: Orlando Health provides more than $450 million in total value to the community in the form of charity care, community benefit programs and services, community building activities and more. Forbes Recognizes Orlando Health as a Best-In-State Employer Forbes has named Orlando Health as one of America's Best-In-State Employers for 2021. Orlando Health is the top healthcare organization in the Metro Orlando area to make the prestigious list. "We are proud to be named once again as a best place to work," said Karen Frenier, vice president, Human Resources. "This achievement reflects our positive culture and efforts to ensure that all team members feel respected, supported and valued." Arnold Palmer Hospital for Care Management Department is seeking a Director. The Director of Care Management leads the care management team in facilitating appropriate use of hospital resources and effective discharge planning and coordination of services to transition patients to the next appropriate level of care. Responsibilities • Manages educational, financial and human resources for the care management teams to deliver high quality, cost effective, and responsive patient-focused health care services. • Coordinates the workload distribution and scheduling of the care management team members to assure adequate and appropriate staffing to meet the needs of patients and families within the Orlando Health network. • Develops collaborative relationships with the site leadership, medicalstaff leadership, managed care contractors, and community leaders. • Supports positive relationships with payors and develops plans to optimize reimbursement and quality of care. • Monitors working DRGs and GMLOS assignment as appropriate. • Implementsthe performance improvement processto include outcome measurement asitrelatesto the identification of processes/strategies/ opportunities that promote population health. • Achievesresults by developing strategiesto manage patient care acrossthe continuum, focusing on high risk, high cost and problem prone areas to include patient at risk for re-admission. • Supports processes for clinical quality/ cost-improvement initiatives/ preventing re-hospitalizations. • Develops recommendations to expand the integration of post-acute care services and hospital operations to better meet the needs of Orlando Health and the community. • Designs educationalstrategies to assure compliance with regulatory standards for NCQA, HIPAA, CMS, and other local, state and federal organizations as applicable. • Coordinates budget implementation with regard to payroll, supplies and miscellaneous other functions that deal with the financial performance of the departments overseen, • Serves as a department intermediary forservice problems. • Ensures incident reports are completed appropriately and follows up with incident reports as needed. • Organizes/leads staff meetings and huddles. • Embraces, promotes and communicates change. • Demonstrates professional accountability by maintaining proficiency in assigned role and involvement in professional organizations and continuing education. • Holds self and others accountable to Orlando Health’s mission, vision and values. • Develops and recommends conceptsrelative to new business opportunities,subsidiary organizations, acquisitions, current business design or other organization structuring to optimize organizational strength and meet operating mission. • Manages various human resources functions including hiring, work assignments, coaching plans, and performance counseling. • Maintains reasonably regular, punctual attendance consistent with Orlando Health policies, the ADA, FMLA and other federal, state and local standards. • Maintains compliance with all Orlando Health policies and procedures. Qualifications Education/Training Graduate of an approved school of nursing, Master’s in Social Work (MSW), Mental Health Counseling (MHC), or Marriage and Family Therapy (MFT). Licensure/Certification • Florida RN license required and maintained current if graduated from an approved school of nursing. Experience Three (3) years of experience in chronic disease management, care management, care coordination, utilization management, or acute clinical care. Preferred to include at least two (2) years in utilization management.• Manages educational, financial and human resources for the care management teams to deliver high quality, cost effective, and responsive patient-focused health care services. • Coordinates the workload distribution and scheduling of the care management team members to assure adequate and appropriate staffing to meet the needs of patients and families within the Orlando Health network. • Develops collaborative relationships with the site leadership, medicalstaff leadership, managed care contractors, and community leaders. • Supports positive relationships with payors and develops plans to optimize reimbursement and quality of care. • Monitors working DRGs and GMLOS assignment as appropriate. • Implementsthe performance improvement processto include outcome measurement asitrelatesto the identification of processes/strategies/ opportunities that promote population health. • Achievesresults by developing strategiesto manage patient care acrossthe continuum, focusing on high risk, high cost and problem prone areas to include patient at risk for re-admission. • Supports processes for clinical quality/ cost-improvement initiatives/ preventing re-hospitalizations. • Develops recommendations to expand the integration of post-acute care services and hospital operations to better meet the needs of Orlando Health and the community. • Designs educationalstrategies to assure compliance with regulatory standards for NCQA, HIPAA, CMS, and other local, state and federal organizations as applicable. • Coordinates budget implementation with regard to payroll, supplies and miscellaneous other functions that deal with the financial performance of the departments overseen, • Serves as a department intermediary forservice problems. • Ensures incident reports are completed appropriately and follows up with incident reports as needed. • Organizes/leads staff meetings and huddles. • Embraces, promotes and communicates change. • Demonstrates professional accountability by maintaining proficiency in assigned role and involvement in professional organizations and continuing education. • Holds self and others accountable to Orlando Health’s mission, vision and values. • Develops and recommends conceptsrelative to new business opportunities,subsidiary organizations, acquisitions, current business design or other organization structuring to optimize organizational strength and meet operating mission. • Manages various human resources functions including hiring, work assignments, coaching plans, and performance counseling. • Maintains reasonably regular, punctual attendance consistent with Orlando Health policies, the ADA, FMLA and other federal, state and local standards. • Maintains compliance with all Orlando Health policies and procedures. Education/Training Graduate of an approved school of nursing, Master’s in Social Work (MSW), Mental Health Counseling (MHC), or Marriage and Family Therapy (MFT). Licensure/Certification • Florida RN license required and maintained current if graduated from an approved school of nursing. Experience Three (3) years of experience in chronic disease management, care management, care coordination, utilization management, or acute clinical care. Preferred to include at least two (2) years in utilization management.
