Community Health Services Manager Job at Hamilton Health Care System
JOB SUMMARY
The Community Health Services Manager is a health professional with in-depth knowledge and background in health care, population health theory, and value-based reimbursement models, stellar communication abilities, in-depth understanding, and autonomy to incorporate management principles and proficiency in electronic health keeping records and clinical integration. In collaboration with the Ambulatory Clinical Quality Manager, the Director of Community Health Services, and the Medical Director, Population Health, utilizes the care coordination team and tracking software to understand and influence readmission factors and utilization patterns. Works in medical practice settings, with hospital teams, post-acute care providers, and the physician and business development team to manage the full continuum of care in the HHCS provider network. Will establish and maintain a post-acute and referral preferred provider network in compliance with relevant federal and state regulation. Evaluates the post-acute referral process to identify opportunities for improvement and overall network integrity in a knowledgeable, skillful, and consistent manner. Works with the physician and business development team to provide feedback to providers and appropriate senior leadership and service line directors. Provides education to physicians and other referral sources regarding post-acute services and network utilization. In collaboration with the Director of Community Health Services, the Medical Director, Population Health, and the Ambulatory Clinical Quality Manager, assists in the development and management of quality project activities including, but not limited to; (a)comprehensive wellness programs (b) quality measure improvement (c) clinical improvement programs (d) overall clinical quality, and (e) value-based health system transformation evaluation and improvement activities. Reviews patient care concerns and identifies resolution of issues to meet patient care needs. In partnership with hospital case management and transition of care team members, reviews readmission rates and readmission retention rates of post-acute providers and leads discussions with those providers to seek improvements in performance, quality of patient care, and network integrity. In cooperation with the Ambulatory Clinical Quality Manager, facilitates MIPS, ACO and other third-party payor value-based reporting. Reviews, assesses, and reports to appropriate leadership, PAC utilization to include ALOS, RUG levels, ED visits and LOS, and multiple PAC transfers. In coordination with the Medical Director, Population Health, engages community resources to identify and mitigate high risk patients based on social determinants of health disparities. The manager is responsible for creating protocols, policies/procedures, and maintaining appropriate documentation of communications with patients, families, providers, and HHCS associates.
JOB QUALIFICATIONS
Education: Preferred Bachelor’s Degree in Nursing, Social Work, hospital administration, or related management field and/or equivalent combination of education and experience from which comparable knowledge and abilities can be acquired.
Licensure: A Current unencumbered Georgia Nursing or Social Work License is preferred.
Experience: Minimum five years of clinical and management experience required. Certification and/or participation in professional organizations recommended.
Extensive experience and knowledge base of all computer systems, applications, and operations including but not limited to those involving physician practice quality measures.
Skills and Core Competencies:
- Dedicated to Services Excellence standards.
- A self-motivated, detail, deadline, and service-oriented individual with strong organizational skills that can accurately set priorities, possesses precise written and verbal communication and excellent interpersonal skills.
- Experience in conducting projects as well as ability to integrate data into process development are required
- Excellent problem solving and critical thinking skills. Strong management and leadership skills required.
- Skilled in the art of human relations, problem solving and conflict resolution/negotiation.
- Demonstrated ability to communicate effectively in person, by phone, and electronically with patients, families/caregivers, physicians, and office staff using appropriate dialogue and customer service competencies to effect positive change.
- Facilitates communication between administration and clinical staff.
- Capable of facilitating learning of others and able to express oneself effectively before groups.
- Demonstrates good role model qualities; ability to effectively interpret, implement and support approved hospital policies, philosophy and objectives.
- Is self-directed in maintaining and improving own competence in skills related to data mining, research analysis, communications, value-based reimbursement models and disease management.
- Capable of effecting positive change across all departments and with medical staff to improve the quality of patient care and the cost of services.
- Intervenes as necessary with all healthcare professionals to assure quality and cost-effective care.
- Performs duties without direct supervision by conducting self in a professional, autonomous manner.
- Working knowledge of Microsoft Office (especially Excel and PPT) and data bases used by HHCS.
PHYSICAL, MENTAL, ENVIRONMENTAL AND WORKING CONDITIONS
Requires corrected vision and hearing to normal range. Manual dexterity and eye-hand coordination is necessary. May require working under stressful conditions. Occasional exposure to communicable diseases, toxic substances, ionizing radiation, and other conditions common to a hospital environment. Frequent contact within community and may require some travel. Requires flexible work schedule as necessary to meet the demands of the position. Requires standing and walking for extensive periods of time. Requires working with computers and prolonged periods of time on the telephone. Duties may require lifting up to 50 pounds.
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