Piedmont Healthcare is a private, not-for-profit organization serving nearly 2 million patients across Georgia. Piedmont is transforming healthcare, creating a destination known for the best clinicians and a one-of-a-kind experience that always puts patients first. Today, more than 110 years since it was founded, Piedmont is known as a leading health system in cancer care, treatment of heart disease and organ transplantation with 11 hospitals, 21 urgent care centers, 28 Piedmont QuickCare locations, 527 Piedmont Clinic physician practice locations and more than 1,800 Piedmont Clinic members. In all, 18,300 employees dedicate themselves to making a positive difference for patients, and the commitment doesn’t stop there. In FY 2017, Piedmont provided more than $215 million in uncompensated care community benefit programming in an effort to better the health and well-being of the people in the communities it serves.
The Executive Director of Care Management is accountable for the leadership and management of care management, social services and utilization management for all hospitals in the Piedmont Healthcare System. This role will develop, coordinate and manage all care management related activities including patient throughput, coordination of care issues, discharge planning and all financial aspects of the utilization management function across the system to meet regulatory requirements, system goals, and local community needs.
The Executive Director of Care Management creates standardization and structure across the Health System for achieving financial sustainability and revenue cycle efficiency, clinical and operational excellence, and patient throughput and safety. S/he also will have responsibility for ensuring that the hospital care management initiatives and programs are coordinated with the Piedmont Physician Enterprise Transitional Care and the Piedmont Clinic Population Health programs and other care management initiatives across the health system. The Executive Director of Care Management will provide direct leadership for corporate utilization management resources and be responsible for authorization of services, as well as leading the clinical denials function. The position also has a dotted line responsibility to lead the Health System’s patient throughput initiatives and must have outstanding communication and coordination skills that will foster good working relationships with corporate revenue cycle, physician enterprise and clinic, hospital CFOs and local directors of care management.
The successful candidate must have solid working knowledge of managed care payment polices and government programs that allow Piedmont Healthcare to adhere to program compliance with federal, state and DNV rules, as well as state and local regulations and guidelines. The Executive Director of Care Management is responsible for creating departmental strategy and program development in conjunction with the system’s Chief Medical and Nursing Officers and the Chief Compliance Officer of the health system. The position reports to the Vice President of Financial Operations, with a matrix relationship with the entity CFOs.
- RN Licensure and/or Bachelor’s degree in relevant clinical field required, such as nursing or social work.
- Master’s degree strongly desired. (MBA, MSW, MHA)
- Minimum of 10 years of clinical experience within a large hospital or health system.
- Minimum of 5 years of management experience in an acute care management setting, preferably in a system or corporate environment.
- Experience in strategic planning and program development at a system level.
- Solid working knowledge of managed care payment polices and government programs.
- Demonstrated ability to lead through metrics and keen understanding of day to day operations.