Executive Director of Care Management

AGH is seeking an experienced nursing leader to assume the role of Executive Director of Care Management. This position reports to the VP, Care Management for the AHN to ensure consistent practice across the health system with dotted line to the CNO of AGH. The Executive Director studies, evaluates, selects and implements systems to facilitate entry of acute care patients to the appropriate facility. Evaluates effectiveness and leads improvement efforts system wide to provide an effective admission structure. Serves as a resource and mentor to the Care Management director team. Assumes responsibility for implementing new care management processes across the system in response to changes in external health care and payer environment.

The Executive Director will implement a case management model and structure to achieve sustaining appropriate length of stay, resource utilization, and clinical outcomes for patients. Responsible for designing and implementing improvement strategies for the care model on an ongoing basis. Oversees all activities related to referral management. Develops collaborative relationships with payers and maintains compliance with payer contracts for utilization management. Acts as a resource and provides ongoing education for department staff as well as system care management leaders, and the organization regarding national and regional trends; adjusts case management model to meet financial, regulatory and clinical goals for AHN in collaboration with the VP Care Management.

Qualifications
  • Master’s Degree in Nursing or related health care field required.
  • Case Management certification preferred.
  • Current RN license to practice nursing in Pennsylvania.
  • Ten (10) years of acute care case management experience required, preferably at a tertiary care center and/or health system.
  • Union experience highly preferred.
  • Five (5) years of progressive management experience required.
  • 3-5 Years of experience with regulations and health finance related to management of patient care required.
The Location

Pittsburgh, PA is an amazing city with incredible architecture, wonderful museums, a commitment to the arts, excellent educational institutions, enthusiastic sports fans, and community members who are dedicated to supporting each other and the beautiful city in which they live.