The Director, Care Management - Population Health works within the Baylor Scott & White Quality Alliance (BSWQA) and will support the strategic development, oversight and execution of the Accountable Care Organization care coordination activities. Experienced Care Management leader responsible for population-health-based Comprehensive Care Management, including Case Management, Disease Management, and Care Coordination programs oversight. This role will also oversee ambulatory social work care managers in the primary care setting in our Temple and Waco regions.
This role will lead the implementation of various patient centered programs and capabilities to coordinate health care delivery to defined populations. Develops and monitors ongoing metrics for evaluations and improvement of patient care. Leads care management resources within BSWQA and provides collaborative support across the system for coordination of care. Maintains knowledge of current and emerging models of care coordination, process standards and related care management trends in the managed care market.
This position can be based in Dallas or Temple, Texas. We will also consider a (mostly) remote or hybrid work arrangement.
Essential Functions: - Works collaboratively with BSWH leadership, clinical departments, Scott & White Health Plan and population health programs to participate in strategic planning, program implementation, and oversight of initiatives in alignment with organizational objectives. - Supports strategic development of population focused care models – identifying population needs, existing resources, and prioritizing priority gaps. - Support efforts to develop virtual and digital health solutions BSWQA members. - Leads care management and ambulatory social work resources in alignment with system initiatives. - Leads efforts to integrate evidence based clinical guidelines, preventative guidelines, protocols and other metrics in the development of treatment plans that promote clinical quality and efficiency in the delivery of healthcare for defined populations. - Develops systems of care that monitor member health status and promote early interventions. - Implements systems of care for Care Coordination Manager and teams that facilitate close monitoring of high-risk members to prevent and/or intervene early during acute exacerbations. - Manages utilization and practice metrics to further refine the delivery of care model to maximize clinical, quality, and fiscal outcomes for defined populations. - Work with BSWQA/Baylor Scott & White Health (BSWH) Leadership to continuously evaluate process, identify problems and propose process improvement strategies to enhance delivery of care models. - Builds strong relationships with BSWQA/BSWH/Health Texas Provider Network networked clinics, participating physicians and staffs to promote care coordination.
Minimum Requirements: - Masters Degree Required - LMSW or RN License - 5+ years of experience - 3+ years of Care Management leadership experience
Baylor Scott & White Health (BSWH) is the largest not-for-profit health care system in Texas and one of the largest in the United States. With a commitment to and a track record of innovation, collaboration, integrity and compassion for the patient, BSWH stands to be one of the nation’s exemplary health care organizations. Our mission is to serve all people by providing personalized health and wellness through exemplary care, education and research as a Christian ministry of healing. Joining our team is not just accepting a job, it’s accepting a calling!