Director of Care Coordination - RN - Hybrid

We are searching for a Director of Care Coordination – someone who works well in a fast-paced setting. In this position, you’ll develop and oversee a comprehensive population health and/or case management strategy to improve the health and wellness of members, psychosocial, environmental, and financial. Defines population health and/or care coordination initiatives and creates a structured, scalable approach to prioritizing and monitoring population health and/or care coordination initiatives, including identifying opportunities for financial savings, driving quality improvement, and ensuring compliance with regulatory requirements.

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Qualifications & Skills

• Bachelor’s degree in Nursing required 
• RN - Lic-Registered Nurses - Texas Board of Nursing or Nurse Licensure Compact required
• 5 years of Supervisory/formal leadership experience required
• 3 years of Managed Care experience required
• 7 years of Experience in population health, community public health, ambulatory care, or healthcare administration required
• Understanding of managed care; preferably experience with Texas Medicaid 
• Experience with public health, including public health promotion and intervention strategies and social determinants of health needs 
• Experience leading, or working closely on, clinical and quality projects to completion 
• Ability to synthesize data and perform ad-hoc data analysis 
• Must be able to work under deadlines and closely with others continuously throughout the day

Job Duties & Responsibilities

• Create and manage a population health and/or case management strategy by identifying and addressing specific needs of members including environmental, psychosocial, and financial. Integrate population health and/or care coordination principles and evidence-based research to develop interventions. 
• Develop new, and enhances existing, interventions to improve HEDIS metrics, and clinical outcomes, and reduce cost
• Sponsor and champion MCO and system-wide initiatives to improve member wellness, including cultivating the support necessary to achieve desired objectives for each initiative.
• Develops approaches, policies, and programs for case management which are based on the TCH goals and objectives and which meet the TCHP performance goals.
• Serve as a liaison with community agencies and other groups and organizations that impact Medicaid health services. 
• Serve as a representative for case management process internally and externally with TCH customers and community partners.
• Ensures the delivery of cost-effective, community-based, and culturally sensitive case management interventions and continuous quality improvement monitoring.
• Collaborates to ensure member outcomes that address values of quality, service, and cost-effectiveness.
• Have direct supervision of a team of clinical and non-clinical staff members. 
• Create and maintain tools to monitor employee productivity and progress. Establish key performance indicators. Track progress and ensure goals are achieved.
• Ensure timely completion of tasks and progression of multiple projects and initiative
• Collaborate effectively with Executive leadership and other leaders of the Texas Children’s system. Utilize presentation skills to demonstrate needs and propose solutions. 
• Communicate positively and appropriately to work effectively as a team. Provide appropriate information at the appropriate level and audience.

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