The Clinical Director, ACO provides clinical leadership and direction in the development and implementation of innovative approaches to ambulatory clinical management with a specific focus on accountable models of care within the MemorialCare Medical Foundation (MCMF). This position will engage and collaborate with local and national organizations on methods and best practices of identifying and improving patient health outcomes, patient satisfaction and efficiencies within an accountable care model. The Clinical Director is responsible for developing and supporting a sound infrastructure and policies and procedures consistent with a state of the art Care Management program. This position will develop an effective and efficient Care Management team within the ACO and will collaborate with operations, care transitions, network development and administrative services within MCMF. This position will be responsible for the development and oversight of ACO program and staff providing ACO care management services.Areas of responsibility include ACO reporting and quality development, inpatient and ambulatory case management and quality/process improvement. The Director will provide leadership and direction to ensure ACO department is in compliance with all applicable ACO standards and contracted requirements and will design and implement ACO care management processes.
Principal Duties and Responsibilities:
* Oversees the clinical operations of the care management team.
* Oversees the hiring and mentoring of Care Management assigned staff.
* Evaluates the NP, LCSW, Clinical Manager and Complex Case Managers.
* Ensures cost effective and quality transition of care through the utilization of appropriate resources.
* Designs and Implements performance improvement initiatives within scope.
* Coordinates activity with post-acute and ambulatory care transition teams to create a patient-centric process, in alignment with system hospitals.
* Develops well-honed relationships with physicians, physician leaders and other providers regarding the flow of patient care within system.
* Collaborates, assesses and makes recommendations to leadership to identify opportunities for improvement in patient care management and optimal process and resource utilization.
* Works with key stakeholders to determine metrics for success.
* Provides information and analysis of performance measurement - identifies better practices to scale within system.
* Develops and deploys team-based care paths that extend and compliment the network physician providers.
* Identified educational/growth goals of the staff. Develops and implements training plans.
* Ensures compliance with joint commission standards, as well as state and federal regulations and requirements
* Bachelor's degree in nursing. MSN or LCSW preferred.
* Professional certification in one or more accepted specialties (nurse executive, case management, health-care executive, social sciences) preferred.
* Five years of hands-on care management experience, preferably in both acute care and ambulatory environment.
* Three years of experience in a leadership/supervisory role required. Care Management leadership experience preferred, especially within at-risk or capitation arrangements.
* An appetite for managing change and a tolerance for ambiguity.
* Ability to both be an effective member of the ACO/ population health team and build formal and informal relationships in order to achieve specific goals and objectives.
* Experience in building teams and programs from the ground up.
* Ability to communicate effectively with diverse constituencies.
* Knowledge and passion for executing Quality, Patient Safety and Performance Improvement programs - by building consensus through complex organizational structures.