Job Description:

At Memorial, we are dedicated to improving the health, well-being and, most of all, quality of life for the people entrusted to our care. An unwavering commitment to our service vision is what makes the difference. It is the foundation of The Memorial Experience.



Summary:



The Vice President of Case Management leads Memorial Healthcare System's execution of the case management and utilization management caregiver workforce. They will develop and retain a dynamic team of CM and UR staff through the promotion of professional practice, ongoing mentorship, and training to ensure system success. The VP is responsible for the coordination of all regulatory audit programs that are associated with reviews of patient records to determine necessity and appropriateness of care rendered to patients. The VP will provide strategic input and overall execute on the strategic plans of the organization while cultivating the collaborative relationships essential to the efficient and effective delivery and management of care. This position will report to the Chief Nurse Executive and will work collaboratively with the facility CEOs, COOs, CNOs, CFOs and corporate Finance.



Responsibilities:



Maintains accountability to administration, physicians and the patients and families related to the case management and utilization review processes. Provides strategic direction and ongoing education to all care partners regarding key elements of Case Management and Utilization Review.Develops, integrates, and implements all components of a system-wide case management/utilization review program including a culture of high reliability. Responsible for planning, education, training, directing, supervision, and communication of all aspects of the CM/UR program. Acts as a liaison to facilitate communication and collaboration between all care partners (physicians, care managers, quality, nursing, support services, managed care, and community agencies and resources). Participates in this evolutionary process by continuously developing and leading robust strategies and operational efficiencies designed to improve patient LOS, improved clinical documentation and timely authorizations for improved quality and patient safety.Facilitates growth and development of the case management/utilization review departments in response to the dynamic health care environment through benchmarking for best practices, networking, quality management, research, etc., to position MHS as a leader in a seamless health care continuum. Ensures safe care to patients by adhering to policies, procedures, and standards, within budgetary specifications, including time management, supply management, productivity, and accuracy of practice.Identifies service enhancements for patients, physicians, and payors, based on statistical and trended analysis of current practice patterns. Is responsible for the management of data collection, aggregation, and dissemination across the enterprise, specific to clinical, financial, and operational performance in case management and utilization review. Establishes and monitors outcome measures and identifies and works to achieve optimal targeted financial outcomes in conjunction with the hospital directors of inpatient case management and utilization review.Responsible for leading a high-performing team who incorporate leadership principles and vision in performing the functions of care management and utilization review. Promotes individual professional growth and development by meeting requirements for mandatory/continuing education, skills competency, and supports department-based goals which contribute to the success of the organization. Serves as preceptor, mentor, and resource to less experienced staff.



Competencies:




Education and Certification Requirements:



Masters: Nursing (Required)Registered Nurse Compact License (RN LICENSE COMPACT) - Compact RN Multistate, Registered Nurse License (RN LICENSE) - State of Florida (FL)



Additional Job Information:



Complexity of Work: This role requires critical thinking skills, effective communication, decisive judgment, and the ability to build and foster positive relationships. The incumbent must be able to lead others and take appropriate action when required. Required Work Experience: Five (5) years of utilization management/care management experience and five (5) years of healthcare leadership experience in a healthcare setting.



Working Conditions and Physical Requirements:

• Bending and Stooping = 40%


• Climbing = 0%


• Keyboard Entry = 60%


• Kneeling = 40%


• Lifting/Carrying Patients 35 Pounds or Greater = 40%


• Lifting or Carrying 0 - 25 lbs Non-Patient = 60%


• Lifting or Carrying 2501 lbs - 75 lbs Non-Patient = 40%


• Lifting or Carrying > 75 lbs Non-Patient = 0%


• Pushing or Pulling 0 - 25 lbs Non-Patient = 60%


• Pushing or Pulling 26 - 75 lbs Non-Patient = 40%


• Pushing or Pulling > 75 lbs Non-Patient = 20%


• Reaching = 40%


• Repetitive Movement Foot/Leg = 0%


• Repetitive Movement Hand/Arm = 60%


• Running = 0%


• Sitting = 60%


• Squatting = 20%


• Standing = 60%


• Walking = 60%


• Audible Speech = 80%


• Hearing Acuity = 80%


• Smelling Acuity = 0%


• Taste Discrimination = 0%


• Depth Perception = 80%


• Distinguish Color = 80%


• Seeing - Far = 80%


• Seeing - Near = 80%


• Bio hazardous Waste = 20%


• Biological Hazards - Respiratory = 20%


• Biological Hazards - Skin or Ingestion = 20%


• Blood and/or Bodily Fluids = 20%


• Communicable Diseases and/or Pathogens = 20%


• Asbestos = 20%


• Cytotoxic Chemicals = 0%


• Dust = 40%


• Gas/Vapors/Fumes = 20%


• Hazardous Chemicals = 40%


• Hazardous Medication = 40%


• Latex = 40%


• Computer Monitor = 60%


• Domestic Animals = 0%


• Extreme Heat/Cold = 0%


• Fire Risk = 0%


• Hazardous Noise = 0%


• Heating Devices = 0%


• Hypoxia = 0%


• Laser/High Intensity Lights = 40%


• Magnetic Fields = 0%


• Moving Mechanical Parts = 40%


• Needles/Sharp Objects = 20%


• Potential Electric Shock = 0%


• Potential for Physical Assault = 20%


• Radiation = 40%


• Sudden Decompression During Flights = 0%


• Unprotected Heights = 0%


• Wet or Slippery Surfaces = 40%

Shift:



Primarily for office workers - not eligible for shift differential



Disclaimer: This job description is not intended, nor should it be construed to be an exhaustive list of all responsibilities, skills, efforts or working conditions associated with the job. It is intended to indicate the general nature and level of work performed by employees within this classification.


Wages shown on independent job boards reflect market averages, not specific to any employer. We encourage candidates to talk to their Memorial Healthcare System recruiter to discuss actual pay rates, during the hiring process.


Memorial Healthcare System is proud to be an equal opportunity employer committed to workplace diversity.


Memorial Healthcare System recruits, hires and promotes qualified candidates for employment opportunities without regard to race, color, age, religion, gender, gender identity or expression, sexual orientation, national origin, veteran status, disability, genetic information, or any factor prohibited by law.


We are proud to offer Veteran's Preference to former military, reservists and military spouses (including widows and widowers). You must indicate your status on your application to take advantage of this program.


Employment is subject to post offer, pre-placement assessment, including drug testing.


If you need reasonable accommodation during the application process, please call 954-276-8340 (M-F, 8am-5pm) or email TalentAcquisitionCenter@mhs.net Apply Now