System Director Care Management
Req #: 40078
Full Time
Shift: Days
WMC Care Management
United Health Services Hospitals
Johnson City, NY
Weekly hours: 40

United Health Services is seeking a full time System Director for Care Management to direct its Care Management program for three hospitals: Binghamton General Hospital, Wilson Medical Center, and Chenango Memorial Hospital. Our Care Management team reviews hospital services on an ongoing basis, evaluates and reports clinical patterns and trends, maintains compliance, and works to improve quality outcomes and ensure patient safety.

The successful System Director for Care Management candidate will join United Health Services’ Quality and Patient Safety Division and report to the VP/Chief Quality Officer.

United Health Services proudly offers competitive compensation and wide-ranging benefits that include health, dental, and vision insurance, tuition assistance, career development opportunities, and paid time off.

Key Responsibilities and Expectations

  • Develop, implement, and annually review the organization’s Utilization Plan
  • Operationalize our Care Management Model across all patient care areas, taking into account demographic differences and achieving consistent application of policies and procedures
  • Identify trends in practices, utilization, or reimbursement that may subject United Health Services to financial risk; work with administration and ancillary departments to develop a plan to reduce or eliminate risks
  • Identify and ensure educational opportunities for department team members to increase knowledge of care management concepts and trends, streamline activities, and improve patient outcomes
  • Propose and champion new programs, system processes, and organization-wide initiatives that improve clinical and financial outcomes
  • Establish and maintain an effective communication/reporting process with medical staff, administration, nursing, and other departments, which will allow them to participate in achieving clinical and financial performance goals
  • Ensure compliance with business ethics, state and federal regulatory requirements, and organizational policies and procedures among direct report
  • Maintain all budgetary duties, which includes developing the annual operating budget and identifying capital and salary requirements
  • Participate in vendor evaluation and identify services not available through United Health Services for consideration
  • Demonstrate professional judgement in decision making, intervention, and follow through; take responsibility for care management services and ensure resolution for each situation
  • Develop and maintain collaborative working relationships with other United Health Services disciplines including Access Care, Finance, and Health Information Management in areas related to level of care, insurance coverage, and compliance
  • Actively promote comprehensive delivery of healthcare across United Health Services and our community and eliminate barriers to effective working relationships among care teams

Position Qualifications

Minimum required:

  • Bachelor of Science in Nursing (BSN) degree or equivalent healthcare-related science field
  • Five years of clinical experience including demonstrated effectiveness in coordinating care for a broad range of high-risk and complex patient cases

Preferred:

  • Master’s degree in a healthcare-related field
  • Certification in Case Management (CCM)
  • Experience in acute care, home care, or managed care
  • Three to five years in a leadership role involving case management, including knowledge of payer mechanism and clinical utilization review criteria
  • New York State Registered Nurse (RN) license or eligibility
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Benefits That Make A Difference

While you’re making a difference in the health and well-being of our patients and communities, United Health Services takes care of you. We are proud to be able to offer our employees and providers a comprehensive benefits package that supports their needs today and for the future with a competitive retirement plan; comprehensive health, dental, vision and health savings and spending accounts; wellness programs that empower our employees to stay healthy and balance work and life goals; group life and disability options; and a generous paid time off (PTO) program. On top of that, we invest in you by offering tuition reimbursement and other programs designed to help you grow your career. The majority of these benefits are available to you for working at least 24 hours per week.

These are just a few of the perks and benefits you can expect when you join the United Health Services team. Be sure to ask your recruiter about all the benefits associated with the position you’re applying for.

Why United Health Services?

We are one of the region’s top employers with an excellent reputation for the care we provide. Our pay, benefits and perks are very competitive. We’re compassionate about patients and respectful of each other. We offer you the stability, size, scope and capabilities of big city health systems, but with the trust and familiarity of more personalized care. We’re engaged with our communities. And, we recognize the importance of work-life balance. Discover the difference you can make, here with us, at United Health Services.

About Our Region

Binghamton, a friendly and close-knit city in Broome County, offers beautiful and affordable homes in downtown, suburban and rural settings, as well as good public and private schools. Nightlife and cultural activities include craft breweries, restaurants and award-winning wineries. First Fridays celebrate local artists and there are frequent music and food festivals. Outdoor activities also abound, from skiing and golf to hiking, biking and more.