Description

Shriners Children’s is an organization that respects, supports, and values each other. Named as the 2025 best mid-sized employer by Forbes, we are engaged in providing excellence in patient care, embracing multi-disciplinary education, and research with global impact. We foster a learning environment that values evidenced based practice, experience, innovation, and critical thinking. Our compassion, integrity, accountability, and resilience define us as leaders in pediatric specialty care for our children and their families.

The Corporate Director of Care Management and Ambulatory Nursing provides enterprise-wide strategic leadership and oversight of care management, utilization management, CDI programs, and ambulatory nursing—including functions, roles, responsibilities, and scope of practice—across all Shriners Children’s locations, including hospitals, ambulatory surgical centers, and clinics. Reporting to the System Chief Nursing Officer, this role partners with clinical, administrative, and financial leaders at local and national levels to standardize practices, strengthen a continuum-of-care model, and advance a data-driven, outcomes-focused, and regulatory-compliant infrastructure. The Director is responsible for optimizing care coordination, transitions of care, resource utilization, discharge planning, and longitudinal patient management while elevating ambulatory nursing practice to ensure high-quality, fiscally responsible care and improved patient outcomes and experience.

Key Responsibilities:

• In partnership with the Chief Nursing Officer and in collaboration with Patient Financial Services, Health Information Management, and Medical Affairs, provides strategic direction and oversight for care management, utilization management, CDI, and ambulatory nursing programs, including the development of system-wide policies, performance standards, and quality criteria aligned with regulatory, accreditation, and payer requirements.
• Develops and executes a comprehensive, system-wide strategy for care management, utilization management, and ambulatory nursing that supports organizational growth, clinical priorities, and a coordinated continuum-of-care model.
• Leads the transformation from site-based practices to a standardized, enterprise-wide model, establishing clear role definitions, accountability structures, and top-of-license practice expectations for RNs and Care Managers across inpatient, ambulatory, and transitional settings.
• Lead and standardize system-wide utilization management programs.
• Demonstrates strategic leadership in planning, implementing, and evaluating programs; sets and executes annual goals and objectives; and leverages organizational and industry data to address variation and achieve key performance targets related to length of stay, resource utilization, patient and provider satisfaction, and outcomes.
• Drives performance improvement through the collection, analysis, and reporting of financial, quality, and utilization data; monitors high-risk, high-cost, and high-utilization trends; and implements system-wide interventions to optimize care delivery, referral management, and contracting strategies.
• Establish an enterprise-wide performance framework with metrics including readmissions, length of stay, utilization, productivity, denials, patient access, referral management and patient experience.
• Ensures alignment and operational consistency across sites by partnering with local leaders to standardize workflows, redesign processes, and implement measurement frameworks reflecting best practices and organizational objectives.
• Identifies and leads initiatives to improve efficiency, maximize revenue, and implement lean processes; convenes and leads multidisciplinary teams to design standardized workflows and scalable solutions.
• Lead performance improvement initiatives to reduce variation and improve outcomes across the system.
• Evaluates and recommends vendor solutions, leads contract negotiations in alignment with organizational priorities, and navigates internal approval processes; prepares and delivers executive-level presentations and recommendations to senior leadership and the Board.
• Integrates innovative and emerging care models, including virtual care, remote monitoring, and cross-continuum pathways, to enhance care coordination, patient experience, and system performance.
• Lead the adoption and integration of innovative care delivery models, including virtual care, remote monitoring, and cross-continuum care pathways to enhance coordination and access.
• Leverage data and analytics to inform staffing models, capacity planning, network strategy, and care model redesign.
• Establish standardized documentation, workflows, and technology-enabled processes to support care management, utilization management, and ambulatory nursing practices.
• Utilize performance analytics to monitor key indicators such as patient access, throughput, referral conversion, and patient engagement, enabling data-driven decision-making and continuous improvement.
• Identifies appropriate marketplace software solution to meet the needs and works with the vendor to onboard the contract.
• Spearheads work groups of internal stakeholders to conduct design and build sessions for new software solutions.
• Demonstrates visionary perspective to envision the best possible efficient workflows and utilization of the software potential.
• Works closely with nursing informaticist to identify needed workflow improvements and educate teams to maximize use of software investments for efficiency and compliance with regulatory requirements,
• Collaborates with SHC Information Systems (IS), informatics and other clinical stakeholders to develop and implement technology solutions that improve care efficiency.
• Provides clinical oversight for design decisions, functionality and training of new technology/tools implemented to support
  care management functions as project lead.
• Effectively implements new requirements utilizing the electronic medical record or other tools to optimize workflow.
• Provide strategic and operational leadership for care management and ambulatory nursing teams across the system.
• Develop and implement competency frameworks for care management, utilization management, and ambulatory nursing, ensuring top of license practice.
• Promote professional certification and ongoing development.
• Identifies and implements contracts with vendors who can assist the organization in recruitment of specialty skill set needed for utilization management, case management and CDI talent.
• Maintains ongoing relationship with vendors and works collaboratively with local leadership resources to fill positions.
• Functions as industry expert on solutions available to the organization and makes recommendations.
• Coaches and mentors local leaders incorporating human resources best practices to develop talent and maximize performance.
• Advises local leaders on action steps to take to manage poor performers.
• Collaborates closely with Human Resources on recommendations for staffing levels and efficient utilization of available positions at sites.
• Participates in the selection process of Directors/Managers of Care Management.
• Provides feedback and annual appraisal input to the Director of Patient Care Services/Nurse Executive relative to the Managers/Directors of Care Management performance. 
• Leads system-wide monthly video/teleconferences with Directors/Managers of Care Management. Provides ongoing education and review of system initiatives while fostering engagement and innovation.
• Actively pursues industry leaders as speakers on topics of relevance to the teams to develop their expose to industry contemporary practice.
• Identifies and assigns appropriate onboarding course work for new hires in this role. Assigns professional development courses to encourage professional development.

Requirements

Required Qualfications:

• BSN
• 5 years Nursing Leadership Experience
• RN License
• Certification in Case Management by one of the following professional certifying organizations or successfully achieved within 6 months of hire is required.
  Commission for Case Management Certification (CCM)
  American Case Management Certification (ACM)
  American Nurses Credentialing Center (ANCC)
  Case Management Administrator Certification (GMAC)
• American Board of Quality Assurance and Utilization Review Physicians ((ABQAURP HCQM) Subspecialty certification in Case Management
   

Preferred Qualifications:

• MSN or Master's in Healthcare
• 2 years Clinical Expereince in Pediatrics
• 2 years Senior Nursing Leaadersihp Expereince