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manager care management
3 months ago
Salary Range: $ $ /hour. Actual compensation may vary based on geographic location, work experience, skill level, and education.
Primary Duties and Responsibilities:
This position is responsible for the daily oversight and management of inpatient and care management staff. This position must support, concurrent, retrospective inpatient review, discharge planning, transitional care and care management programs for Hoag MG and IPA assigned membership. They are responsible for helping to develop and implement any necessary P&P's and workflow to ensure consistency, effectiveness and efficiency in the use of all resources required to accomplish all department goals and objectives. They will identify any opportunities for and implement any changes necessary to improve upon workflows and department performance that will ensure a high level of satisfaction with our customers and compliance with all Federal, State and Health Plan requirements. They will monitor the department performance against these requirements. They will be a resource to staff for addressing difficult issues that arise within the department. Interface with Medical Directors, hospitalists, physicians, other department leaders and vendors as needed.
Education and Experience:
Current RN license in the State of California
BSN or Bachelor Degree in Health Care related field
Minimum of 2 years of supervisory experience required in medical group or health plan setting
Experience of at least two years with Inpatient Case Management and/or Outpatient Care Management
Have an understanding of nationally recognized criteria Milliman Care Guidelines/Interqual/CMS, etc.
License Required:
Active unrestricted RN license in the State of California
