State of Maine License required
Minimum 3 years experience required
The director of integrated care management is an executive leadership position that requires clinical experience and an advanced degree. Individuals in this role must also possess comprehensive knowledge of the healthcare industry, knowledge of population health management, strategic planning skills, an understanding of the operations of a healthcare organization, and familiarity with government regulations on healthcare plans. Individual must be an experienced manager and leader whose work experience has given them exposure to various segments of the health system and the insurance world.
The director is responsible for coordinating and facilitating multiple internal and external resources into a unique and single approach to care coordination for each patient assigned care management services. The director will identify and implement processes that support and promote efficient patient transitions across the healthcare continuum resulting in optimal clinical outcomes, appropriate utilization of resources, accurate reimbursement when appropriate and compliance with federal, state and payor regulations and guidelines. The director will provide leadership, communication, and supervision to the department staff to ensure organizational and facility strategy is operationalized. Care management staff will develop care plans with patients and their families as the center of the team to ensure that the treatment being received will lead to desired health results and accountable care goals/metrics.
Must have either a current State of Maine Registered Nurse (RN) license or an RN license recognized by the Nurse Licensure Compact ( https://www.ncsbn.org/nlc.htm ). If RN licensure is from a compact state, must obtain a state of Maine RN license within 90 days of changing primary residency to Maine.
CCM Certification preferred.
Graduate of an accredited program of nursing and/or degree in Care Management or Social Work required; Master’s level degree in related field required.
Minimum of three (3) years’ clinical experience required. Minimum of two (2) years of care management experience preferred. Must be self-directed, professional and exhibit leadership qualities. Must have excellent problem solving, interpersonal and communication skills. Proficient in a suite of Microsoft Office applications Comprehensive knowledge of healthcare principles and practices required. Excellent critical-thinking, problem-solving and analytical skills required. Organizational skills and effective time management skills required. Must have the ability to lead and motivate others. Must demonstrate strong self-initiative and interpersonal communication skills. Fluency in the compliance and regulatory standards governing health plans and patient care required. Proficiency with computers and a talent for population health and data analysis.
MaineGeneral Health - 24 months ago