Director, Clinical Care Coordination & Discharge Planning

Purpose:

The Director provides administrative oversight and personnel management for the Clinical Care Coordination and Discharge Planning Department. The Director delivers leadership across the organization to support continuous improvement in medical management, clinical resource utilization, cost control, and cost effectiveness, with the goal of achieving optimal hospital reimbursement for services provided.

This role functions as a key liaison to external agencies and vendors supplying post-acute care services, as well as to insurance companies, to establish and maintain effective working relationships that support positive medical management outcomes and reimbursement for patients.

Responsibilities:

• Directs all activities and processes related to daily departmental operations.
• Provides oversight of Clinical Care Coordination and Discharge Planning Department operations, ensuring leadership is well informed regarding current operational status, barriers impacting length of stay, bed capacity constraints, patient complaints, and overall process efficiency.
• Maintains overall responsibility for managing activities related to utilization of resources and proactive, efficient discharge planning to support effective patient movement across the continuum of care.
• Responds to department-wide staff and staffing issues and needs, including vacancies, staff complaints, scheduling, recruitment efforts, and position justifications, as appropriate.
• Establishes and monitors staff performance, providing ongoing feedback and guidance. Conducts annual performance evaluations.
• Facilitates the determination of benchmarks for clinical and service monitoring in collaboration with departmental and system leadership.
• Creates Discharge Planning goals in partnership with senior leadership.
• Ensures that monitoring and staff education processes support the achievement of departmental goals and objectives.
• Ensures maintenance of operational efficiency across all areas of responsibility in order to promote compliance with Joint Commission (JCAHO standards, state Department of Health (DOH regulations, and requirements of other applicable regulatory agencies.
• Directs activities related to special projects involving utilization management, resource consumption, and the efficient movement of patients across the continuum of care.
• Ensures compliance with departmental work plans and established goals.
• Provides day-to-day departmental management.

Qualifications:

• Master's Degree required.
• Minimum of five (5 years of experience in discharge planning, care coordination, or similar experience managing departmental operations.
• Minimum of two (2 years of commensurate leadership experience.
• Strong knowledge of clinical care, discharge planning processes, and current regulations related to utilization management, clinical care coordination, and discharge planning.
• Ability to build credible and effective relationships with physician leadership.
• Demonstrated ability to prepare, critically analyze, and interpret data; make appropriate recommendations for resolution; and follow through on identified actions.
• Expertise in interpersonal relationships and organizational relations.
• Effective communication, negotiation, and conflict resolution skills.
• Strong analytical and critical thinking skills.
• Demonstrated leadership capabilities.
• Strong quality improvement expertise.
• Knowledge of healthcare revenue cycle processes and requirements.

Licensure, Certifications, and Clearances:

• Licensed Clinical Social Worker (LCSW OR Licensed Social Worker (LSW OR Other Healthcare Professional Licenses for Discharge Planning OR Registered Nurse (RN or education-appropriate license required
• Act 34
• Certification: CCM/ACM required
• Current licensure either in the state where the facility is located or, if the facility is in a state covered by the multistate Nursing Licensure Compact (NLC agreement, a multistate license issued by a participating NLC state. Hires and current employees working on an out-of-state NLC license who later change their residency to the state where the facility is also located will have 60 days upon changing their residency to apply for licensure within that state.

UPMC is an Equal Opportunity Employer/Disability/Veteran