ACNO, Care Progression

Job Description Summary

The Associate Chief Nursing Officer (ACNO) for care progression supports the Chief Nursing Officer (CNO) responsible for driving, supporting and modeling a culture focused on employee engagement, quality, patient safety, fiscal responsibility, and the overall patient experience. The ACNO, Care Progression demonstrates and leads by example the behaviors to the American Nurses Association (ANA) Nursing Code of Ethics, Nursing Scope and Standards of Practice, and their associated specialty Scope and Standards of Practice. The ACNO, Care Progression oversees and sets the direction for numerous health system programs and objectives, including: case management across the continuum of care, primarily encompassing hospital care progression, social work and utilization review with approximately 20% of the role affecting care transitions, cross-continuum coordination and innovations in care delivery; the health system’s relationships with local partners, including coordination of patient placements, patient services, patient advocacy and contractual agreements; discharge planning adherence with the conditions of participation and asserting professional principles; lead projects related to readmissions, length of stay, appropriate reimbursement, performance improvement, care quality and cost-effective outcomes at the correct level of care including palliative and end of life care. This ACNO embraces the guidance, principles and best practices outlined by the two professional organizations that support Care Management, Academy of Certified Case Managers (ACCM) and Commission for Case Manager Certification (CCMC).

Job Description

ESSENTIAL FUNCTIONS

Leadership:

The ACNO provides leadership and strategic planning to operationalize care management services and develops a coordinated approach to care management across the continuum, including the development of a post-acute care strategy.

Collaboration:

Actively collaborates with Utilization Management, Providers, Finance and the delivery system to develop clinical strategies to reduce admissions that do not meet medical necessity to reduce length of stay (LOS), improve transition planning and to reduce payment denial rates. Assures that the hospital has an effective Complex Care Extended Long Length of Stay forum. 

Payer Relationships:

Oversees all activities related to referral authorization management. Develops collaborative relationships with payers and maintains compliance with payer contracts for utilization management. Engages in payer contract discussions by providing recommendations on terms and conditions. 

Management:

The ACNO has direct reporting responsibility for inpatient care management departments at the hospital. Works with the Chief Nursing Officer and medical staff leadership to evolve the organizational model to meet patient care needs. Facilitates the delivery of safe, high quality care through clinical and non-clinical care management coordination, ongoing process evaluation, and reviewing clinical outcome metrics.  Responsible to continuously evaluate and advance the Clinical Care Management model assuring best use of Registered Nurse, Social Work and other colleagues skill sets; proactive identification of and intervention with patients; continuity of assignments whenever possible and adequate Care Manager and Social Work coverage for all care settings. Develops strategies to leverage resources to advance professional growth, spread best practices, and provide flexible staffing options. Convene, lead and monitor regional work groups as indicated to address opportunities. Measures, analyzes and reports key metrics related to care management across the care continuum. Obtains, utilizes and leverages existing data for improvement of patient flow and other key performance indicators. Facilitates development and distribution of reports. The ACNO will develop a dashboard for related to their core activities to present to their team, collaborators and senior leadership presenting at least monthly.

Care Transition Partnerships:

Identifies and acts upon opportunities to coordinate services between inpatient, outpatient and community settings. Forms community relationships and works to identify gaps in the continuum of care. Understands and promotes the use of community resources to improve the patient experience. Promotes and maintains positive relations with continuum of care providers.

Leadership:

Models and fosters an environment of professionalism and compassionate care. Guides the recruitment, retention, and employee engagement that keeps high performers engaged and maintains focus on succession planning. Acts as a role model through the demonstration of personal professional development, continuous learning and competency improvement.

Efficiencies:

Partners with medical staff and clinical services operations to become more efficient and effective in achieving total cost of care objectives, in alignment with clinical quality and access objectives.  Identifies and implements best practices related to: Clinical Care Management, Utilization Management, Chronic Disease Management, Health Promotion, Care Transitions and Transition Planning, Post-acute Services, Social Work, Hospital Throughput, Patient Placement, LOS Management, and other related areas as indicated.

Liaison:

Serves as liaison for statewide care management-focused initiatives and for project related activity within South Shore Health.  Actively participate in professional, political and regulatory organizations policy, practice, payer and regulatory communications and convening meetings.

Xsolis:

Manages care management software and contracts. Identifies and acts upon the need for software tools to support effective care coordination. Collaborates to optimize use of existing tools

Budget

The ACNO has full responsibility for planning, monitoring and managing department budget.

Human Resources Management

Management Actions

• Coordinates with Human Resources for the interviewing, hiring, personnel transactions (e.g., hiring, salaries, promotions, job descriptions) and implementing of institutional corrective action policy for staff.
• Using Workday, initiates, approves, and coordinates with Human Resources for approval of human resources changes (e.g., salary adjustments, salary distributions, training records) for staff who reside under their team.
• Prepares performance reviews on direct reports.
• Takes corrective and disciplinary action, up to and including termination, as necessary to maintain the highest level of staff productivity and effectiveness.

Oversight

• Provides direct supervision to, and is responsible for, the conduct, operations, and results of their team.
• Develops and implements change management programs including efficiency and resource utilization projects.
• In times of transition, supports areas that require interim leadership support.

Development

• Actively considers opportunities to grow the abilities, skills, and support of colleagues responsible areas through professional development, enhanced communication vehicles, employee-focused initiatives, and otherwise.

Culture/Equity

• Reviews, supports, and ensures salary and wage equity for staff.
• Creates a supportive, educational, and development-focused environment for all staff.
• Ensures the support and maintenance of a diverse, inclusive, and professional environment for all staff.

Compliance

• Develops, implements, oversees, and approves departmental policies, procedures and systems and revises as necessary to maximize efficiency.
• Responsible for ensuring compliance with regulatory bodies and making managers aware of policy and procedure changes.

Other

• Develop letters, presentations, announcements, and other communications.  All documents must be of the highest caliber of refinement and professionalism.
• Serve as a stand-in for the CNO in relevant meetings when the CNO is not available.  Serve on committees as needed or assigned by the CNO.
• Lead or participate in special projects and perform other related tasks as requested or required.

JOB REQUIREMENTS
Minimum Education - Preferred

MSN (or) MS with a BS in Nursing, doctorate preferred

Minimum Work Experience

Minimum five years of experience required as a clinical nurse with demonstrated evidence of leadership progression; most recent 3 of the last 5 years of leadership must have been in a direct leadership role in a hospital setting or direct patient care environment required or equivalent combination of education and/or experience. Demonstrated success as an ACNO in Care Management or Care Progression strongly preferred.

Required License/Registration

RN - Current Massachusetts Registered Nurse License without restrictions required

Current certification preferred or to be attained within two year period from date of hire

Professional nursing certification must be maintained while employed in this position

Required additional Knowledge, and Abilities