The Director of Outpatient Continuing Care provides leadership, direction and oversight of all outpatient continuing care activities. This position is responsible for establishing efficient and organized processes to support excellent quality and service. The Director of Outpatient Continuing Care partners with other leaders from the Health Plan and MAPMG to ensure execution of program goals.
Develops and implements all components of the outpatient case management program and ensures compliance with NCQA, state, federal and other regulatory accreditation standards.
Provides leadership and direction in the design and implementation of workflows and processes to promote timely and smooth transitions of care between inpatient and community settings.
Partners with health plan and MAPMG staff to develop strategic plans, providing quality and cost effective care in the outpatient setting.
Develops and maintains relationships with external vendors and providers.
Develops and implements processes to support efficient management of outpatient continuing care teams.
Participates in developing CM work plan and ensures adherence to all quality and operational initiatives and goals.
Manages budget performance and executes appropriate strategies to manage cost and improve quality of care and services.
Partners with other members of the Continuing Care team to develop and implement collaborative processes and outcomes.
Supports professional growth by providing education, training and appropriate resources. Conducts performance evaluations, provides coaching and acts as a mentor to direct reports.
Performs other related duties as assigned.
Ten (10) years of experience in a clinical setting.
Five (5) years of experience in Utilization Management or Case Management.
Five (5) years of experience in a management or leadership position.
License, Certification, Registration
Valid RN license in DC, MD or VA.
May be required to obtain additional state licenses as appropriate.
Proven track record of developing and implementing major projects on time and within budget required.
Proficient in computer applications including Microsoft Word, PowerPoint and Excel required.
Strong interpersonal skills, with good verbal and written communication skills required.
Skills in problem-solving and collaboration with other professions/ disciplines required.
Demonstrated experience in complex strategy formulation and implementation required.
Ability to work comfortably and effectively with senior management & physicians required.
Understanding of or experience working with state Medicare / Medicaid plans.
Understanding of or experience with NCQA or other accreditation guidelines.
Master's degree in nursing, health care administration or other health related field.
Certification in Case Management from Commission for Case Manager Certification or Nursing Case Manager Certification from American Nurses Credentialing Center.
Kaiser Permanente is an equal opportunity employer committed to a diverse and inclusive workforce. Applicants will receive consideration for employment without regard to race, color, religion, sex (including pregnancy), age, sexual orientation, national origin, marital status, parental status, ancestry, disability, gender identity, veteran status, genetic information, other distinguishing characteristics of diversity and inclusion, or any other protected status.
External hires must pass a background check/drug screen. Qualified applicants with arrest and/or conviction records will be considered for employment in a manner consistent with federal and state laws, as well as applicable local ordinances, including but not limited to the San Francisco and Los Angeles Fair Chance Ordinances.
TITLE: Director, Outpatient Continuing Care
LOCATION: Rockville, Maryland
External hires must pass a background check/drug screen. Qualified applicants with arrest and/or conviction records will be considered for employment in a manner consistent with Federal, state and local laws, including but not limited to the San Francisco Fair Chance Ordinance. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, sexual orientation, gender identity, protected veteran, or disability status.