Director of Care Coordination and Utilization Management

 
Position: Director of Care Coordination and Utilization Management

Job ID: 164679

Location: US-TX-Houston

Department: UTILIZATION MANAGEMENT

Talent Area: Professional - Clinical

Full/Part Time: Full-Time

Regular/Temporary: Regular

Shift: 8a -5p

About Texas Children's Hospital

Since 1954, Texas Children’s has been leading the charge in patient care, education and research to accelerate health care for children and women around the world. When you love what you do, it truly shows in the smiles of our patient families, employees and our numerous accolades such as being consistently ranked as the best children’s hospital in Texas, and among the top in the nation by U.S.News & World Report as well as recognition from Houston Business Journal as one of this city’s Best Places to Work for ten consecutive years.   Texas Children’s comprehensive health care network includes our primary hospital in the Texas Medical Center with expertise in over 40 pediatric subspecialties; the Jan and Dan Duncan Neurological Research Institute (NRI); the Feigin Center for pediatric research; Texas Children’s Pavilion for Women, a comprehensive obstetrics/gynecology facility focusing on high-risk births; Texas Children’s Hospital West Campus, a community hospital in suburban West Houston; and Texas Children’s Hospital The Woodlands, a second community hospital opening in 2017. We have also created the nation’s first HMO for children, established the largest pediatric primary care network in the country and a global health program that is channeling care to children and women all over the world. Texas Children’s Hospital is also academically affiliated with Baylor College of Medicine, one of the largest, most diverse and successful pediatric programs in the nation. To join our community of 14,000 dedicated team members, visit texaschildrenspeople.org for career opportunities. You can also learn more about our amazing culture at infinitepassion.org. At Texas Children’s Hospital, diversity, equity, and inclusion are at the core of our values and mission for the women and children that we serve. We are committed to providing a diverse and inclusive work environment for all faculty, staff and learners throughout our organization. We believe that each member of our one amazing team provides enrichment that allows us to create a lasting legacy for future employees of this great organization.   Texas Children’s is proud to be an equal opportunity employer. All applicants and employees are considered and evaluated for positions at Texas Children's without regard to mental or physical disability, race, color, religion, gender, national origin, age, genetic information, military or veteran status, sexual orientation, gender identity, marital status or any other protected Federal, State/Province or Local status unrelated to the performance of the work involved.

Summary:

We are searching for a Director of Care Coordination and Utilization Management -- someone who works well in a fast-paced setting. In this position, you will provide 24-hour accountability for the clinical, administrative, and human resources activities within the Care Management department. Ensure the delivery of high-quality, cost-effective, developmentally appropriate patient care in a family-centered care environment. This leader will strategically partner, lead, create, and implement staffing and programming to support the organization's goals related to these areas of responsibility.

 

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Responsibilities :

  • Responsible for ensuring patient care delivered by the Care Management department is safe, high quality, age-appropriate, cost-effective, and efficient care. Advocates for departmental resources necessary to achieve desired clinical outcomes. Monitors patient satisfaction to align with organizational goals and initiatives. Ensures regulatory compliance is met for all clinical standards of patient care
  • Establishes maintains and builds effective working relationships with medical leadership, direct reports, and appropriate interdepartmental liaisons to ensure the achievement of identified goals. Provides insight and expertise on development or program initiatives. Promotes ongoing development of staff and creates a work climate that fosters employee participation, satisfaction, and organizational commitment
  • Actively leads and participates in quality improvement initiatives to enhance patient care and delivery. Creates and implements departmental customer service standards. Ensures accreditation and regulatory requirements are met/ Develops robust data management system to provide historical record-keeping and predictive analytics
  • Develops and prioritizes service-based goals that support the organization’s mission, vision, and overall strategic plan. Manages service lines across the system as a whole and collaboratively works together with all hospital campuses toward one shared vision
  • Provides fiscal management of departmental budget and operations. Overseas operations related to budgeting, staffing, and management of staff, grants, and contracts. Reports financial performance monthly to executive leadership
  • Partners intentionally and strategically with care coordination leadership at Texas Children’s Health Plan, leveraging data to drive decision making, to ensure consistent execution of care coordination vision across entities


Qualifications:

Being fully vaccinated against COVID-19, including any booster dose(s) of the COVID-19 vaccine recommended by the Centers for Disease Control when eligible, is required for all employees at Texas Children’s unless approved for a medical or religious exemption.

  • BSN and Master's Degree in nursing, business, or healthcare
  • Licenses/Certifications: RN - Lic-Registered Nurses
  • 5 years’ experience in nursing, including 3 years of management/leadership experience


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