SCL Health is a $2.6 billion faith-based, nonprofit healthcare system based in Denver, Colorado that is dedicated to improving the health of the people and communities we serve, especially those who are poor and vulnerable. We operate 12 hospitals, 210 ambulatory service centers, home health care, hospice, mental health care and safety-net service facilities over five distinct markets across Colorado, Kansas and Montana with more than 15,000 associates and 700 employed providers. Founded by the Sisters of Charity of Leavenworth in 1864, SCL Health provides more than $222 million in benefits annually to the communities it serves and has been recognized among Truven’s Top 15 Health Systems nationally. We relentlessly focus on delivering safe, high-quality, effective care to every patient, every time, everywhere.
As Vice President Care Management, you would be responsible for building the Care Management department for the system, including community-based case management, inpatient and outpatient. Direct reports include all care-site Directors Care Management, Directors Social Work, and Utilization Review staff in our care sites and clinics. SCL Health strives to leverage the benefits of a highly efficient operating model company with the defined objective of being the “Number One Leader” in coordinating care in the areas we serve. As a member of the system executive leadership team you will participate in planning, organizing and implementing programs and activities across the system and its hospitals in accordance with the mission and values of SCL Health.
In this newly created position of Vice President Care Management, you will have the opportunity to design and implement a new system-wide care management process. You will be responsible for the provision of leadership, direction, oversight, and operations management for the Case Management, Social Work, Navigation and Utilization Review Programs across all lines of business for all SCL Health facilities.
Additionally, in this key executive role you will:
Hold accountability for the strategic and operational excellence of the case management across system Clinical Services including administrative and care cost initiatives, system development and delivery of high quality outcomes, compliance with all State and Federal regulations that affect Case Management activities and executive level reporting and communication. Translates organization strategy into goals, action plans and metrics for the assigned department(s). Creates purpose and meaning for department(s) and clearly communicates and links purpose and meaning to organizational goals. Measures success and improves Care Management processes.
Develop plans and strategies to minimize clinical denials working collaboratively with key partners at the hospital level including, but not limited to, C–Suite, and Clinical Services [including Utilization Management, Clinical Documentation Improvement, Performance Improvement, Medical Review and Appeals, Business Office operations, Pharmacy Utilization and Provider Integration]. Ensure structure at the Care Sites and System level utilizes resources and establishes effective partnerships with payers and Physicians.
Evaluate resources providing Hospital and Community Case Management (internally and externally), Navigation, and others to leverage resources and care processes effectively. Responsible for the oversight, management and optimization of all activities as they relate to inpatient, outpatient, palliative, home health, DME and other healthcare delivery programs internal to system or in partnership with system to ensure effective care coordination and deliver across the continuum. Oversee service needs and volumes. Direct management team in managing staffing levels and productivity. Provide communication to management team and department associates through huddles, staff meetings and other forms of communication to relay updates regarding department updates, organizational activities, financial performance, educational opportunities, interdepartmental activities and QI activities.
Participate, with other System and Care Site resources including Transformation and Innovation, in the development and implementation of programs to ensure that patient care coordination and case management improve quality, continuity, and resource utilization in the most appropriate setting. Ensure effective working relationships within the department/unit team and interdepartmentally within the care site/location. Lead and participates in interdisciplinary committees throughout the organization.
Direct human resource functions such as interviewing, selection, orientation, education/training, feedback, performance evaluation, and policy and procedure development. Oversee the maintenance of personnel files, including documentation of appropriate staff orientation, competency, training, discipline and performance reviews. Oversee department timekeeping and payroll. Collaborate with Human Resources concerning employee issues and performance. Conduct employee coaching, counseling, disciplinary actions and annual appraisals. Ensure staff adherence to hospital and departmental policies and procedures.
Prepare the operational and capital budgets. Monitor and reports the performance of the department against budget. Develop annual operating plans, business plans for new services and changes in the organizational structure in the department. Present business plans, reports, and other statistical data to executive leadership team. Oversee capital equipment purchases and instrument service contracts.
Identify and drive quality and performance improvement initiatives. Create and interpret key performance metrics to develop system plans that mobilize the work force and achieve, maintain and improve the case management outcomes relative to improved experience of care and appropriate resource utilization. Ensure compliance with applicable regulatory guidelines and established departmental policies and procedures, objectives, quality assurance program, safety, environmental and infection control standards. Develop action plans in line with the organization's strategic initiatives and goals.
Participate in the Talent Management program. Mentor and provide development opportunities for leaders and identified high potential associates to ensure effective succession planning.
We expect excellence, which is why we require:
Bachelor’s degree in nursing.
Master’s in Healthcare or related field.
10 years’ experience in Case Management.
5+ years’ experience in a leadership position over multiple care sites or a health system.
ACM or CCM Certification is preferred.
Procedure for candidacy and confidential consideration: