Director of Referral Management & Transitions of Care

Job Overview

The Director of Referral Management and Transitions of Care is responsible for developing and executing the agency sales/marketing and referral growth plan consistent with the strategic plan and objectives of the organization to drive patient volume and revenue, as well as referrer/ customer satisfaction. Directs and manages multiple departments consisting of Liaison nurses/sales staff (Hospice and VNA) and Intake department staff. Develops and fosters positive customer and provider relations internally and externally. Identifies, recommends, and implements changes in marketing direction. Increases community awareness of TMCAH and through presentations to external referral sources and the community in general, as needed in partnership with corporate communications and clinical leadership. In partnership with TM entities and staff, participates in program development and fosters collaboration and integration of TM CAH into System activities. Participates in cross organizational strategy meetings for VNA, Palliative and Hospice, to identify needs and implement organizational change

Job Description

Minimum Qualifications:

1. Bachelor's degree in Nursing (BSN).

2. Massachusetts RN Licensure OR Current multi-state licensure through the enhanced Nurse Licensure Compact (eNLC).

3. Five (5) years of progressive leadership within home care or other health care setting with strong emphasis on home care experience and referral management.

Preferred Qualifications:

1. Master's degree in Business, Health Care Administration, Nursing, or related field.

Duties and Responsibilities: The duties and responsibilities listed below are intended to describe the general nature of work and are not intended to be an all-inclusive list. Other duties and responsibilities may be assigned.

1. Works with the President and CAH leadership to identify services that are consistent with agency mission and goals and have potential to be developed as programs that enhance the quality of patient care and/or improve operational efficiencies.

2. Key representative of the organization for transitions of care with acute care, SNF, and physician community to describe and promote services and programs. Representative on area PHOs and transformational committees to advance the full continuum of care and services in the home. Assumes a leadership role when assigned in leading or participating in organization Committees or task forces. Participates as member of TM CAH, Home Health, Hospice, and Palliative Management, leadership teams. Maintains positive, collaborative attitude.

3. Ensures compliance with all local, state, federal, and accrediting requirements within the scope of work for self and staff in the departments.

4. Ensures marketing plans are developed, in collaboration with senior leadership, and implemented in concert with the overall strategy plan and objectives of the organization.

5. Responsible for mentoring, coaching of direct reports and others. Interviews, hires, evaluates, and mentors personnel.

6. Advocates for change as appropriate.

7. Maintains body of knowledge in the areas of clinical care, finance, technology, informatics, environmental and community clinical care.

8. Active participant in community organizations and committees.

9. Reports and performs data analysis of Epic data, for maximizing referral management and strategy effectiveness.

10. Active participant in new agency programs conception and implementation. Works with other key Directors to ensure program growth and sustainability.

11. Manages messaging regarding capacity management; balancing clinical limitations with needs of referral sources to ensure smooth transitions, working with TMCAH leadership.

12. Ensures compliance with hospice regulations and conditions of participation for direct reports, and hospice liaisons.

13. Responsible for the planning and execution of approved operational budgeting of the scope of the respective departments.

14. Monitors liaison territory to assure that accounts are appropriately assigned and covered.

15. Nurtures and builds client (internal and external) relationships.

16. Preserves and strengthens agency's niche as a home health and hospice provider within the TM health system and beyond, to grow presence and reliability in the home care space and market share.

17. Defines qualifications, responsibilities, and functions of staff, in collaboration with supervisor. Assists other leaders/directors in establishing appropriate staffing requirements within the program.

18. Ensures performance improvement is a foundational aspect of the program and appropriate indicators are in place to monitor accounts and outcomes.

19. Maintains operational oversight, budgeting, accountability, and or influence for the following: Intake department, Liaison/referral management program and hospice admission team with delegated authority; Liaisons (VNA and Hospice).

20. Maintains the confidentiality and security of all agency and system- related, physician-related and patient-related data and information and for complying and upholding requirements of the Department of Public Health; the Centers for Medicare and Medicaid Services (CMS); the Boards of Registration in Nursing and Allied Health, and other licensing boards as determined by scope of service; all state, federal and other regulatory bodies; and the laws governed by the Commonwealth of Massachusetts and the state of New Hampshire.

21. Acts as a team player with management staff to handle problems in a proactive manner.

22. Attends appropriate conferences, CEU programs, and seminars to keep up to date with professional practice and current trends in management.

23. Reports Compliance concerns to the President or Chief Compliance Officer when applicable.

24. Ensures compliance within guidelines set forth by regulatory agencies (DPH, ERISA etc.) and demonstrates compliance with Tufts Medicine Care at Home policies and procedures.

25. Strengthens internal operations to ensure processes are effective for changes in the industry.

26. Utilizes analytical and statistical data, and other data needed for program evaluation, revision, etc.

27. Assists in resolving complex employee relation issues.

28. Provides direct support for quality improvement work to be performed.

29. Identifies areas that require process improvement and makes recommendations for same.

30. Directs or participates in performance improvement initiatives as needed.

31. Coaches and develops all teams to achieve maximum potential.

32. Sets goals and monitoring performance toward goals.

33. Makes/recommends appropriate operational adjustments to assure advances in goal achievement.

34. Monitors all direct patient clinical staff for performance accountability and maintains documentation on employee performance.

Physical Requirements:

1. Standing and walking for extensive periods of time.

2. Occasionally requires lifting and carrying items weighing up to 10 pounds.

2. Frequent exposure to hazardous chemicals, sick patients, bodily substances, noise and possible exposure to radiation, lasers, electric shock, etc.

5. Regularly exposed to the risk of bloodborne diseases and other transmissible infections.

6. Contact with patients under wide variety of circumstances.

7. Subject to varying and unpredictable situations.

8. Ability to handle emergency and crisis situations.

9. Subjected to irregular hours.

10. May have contact with hazardous materials.

Skills & Abilities:

1. Strong leadership and emotional intelligence skills.

2. Tact, diplomacy and sensitivity in dealing with customer and staff relations.

3. Maintains body of knowledge to keep abreast of current trends and policy development at the state and national level.

4. Ability to communicate effectively, both verbally and in writing.

5. Good analytical and budget management skills.

6. Exercises independent judgment.

7. Ability to delegate.

8. Utilizes critical thinking skills.

9. Ability to speak confidently and present with strong knowledge base in a confident manner.

10. Strong critical thinking skills and ability to assess and synthesize data for planning and assessment of outcomes.

11. Ability to write and develop materials for target populations.

12. Ability to function well in very busy situations.

13. Responsible and reliable.

14. Good organizational skills.