Director, Inpatient System Care Management
5 days ago
Summary
Alameda Health System offers outstanding benefits that include:
* 100% employer health plan for employees and their eligible dependents
* Unique benefit offerings that are partially or 100% employer paid
* Rich and varied retirement plans and the ability to participate in multiple plans.
* Generous paid time off plans
Role Overview:
Alameda Health System is hiring Under the direction of the Vice President of Care Management, the Director of Inpatient System Care Management manages the day to day operations of the inpatient Care Management across all AHS facilities, including post acute care facility for ensuring efficient patient flow, beginning when a patient is admitted to the facility and ending with a safe and clinically appropriate discharge.
DUTIES & ESSENTIAL JOB FUNCTIONS: NOTE: The following are the duties performed by employees in this classification. However, employees may perform other related duties at an equivalent level. Not all duties listed are necessarily performed by each individual in the classification.
* Accountable for Patient Care Coordination activities including system-wide Case Management, Care Coordination and Discharge Planning.
* Aligns Case Management with AHS strategic and operational objectives.
* Optimizes efficient Care Management/care coordination roles and processes; initiates process improvements.
* Develops, monitors and evaluates inpatient Care Management Metrics; manages the collection, analysis and presentation data relevant to the utilization of healthcare resources including but not limited to avoidable/variance days, readmissions, one-day stays, DRGs, LOS.
* Develops, maintains and implements Case Management policies, practices and procedures in accordance with CMS, CA DCHS, the Joint Commission, Title 22 and other regulatory agencies and overall hospital policies; integrates managed care contract criteria into overall Case Management functions.
* Works closely with the VP of Care Management and Physician Advisors on any audits and secondary reviews; may include but not limited to Direct and coordinate data gathering, chart audits and participants in internal and external meetings.
* Oversees educational needs and plan for inpatient Care Management division.
* Recruits, trains and coaches the management staff to assist them with performing optimally and provides appropriate discipline/structure; consults and assists Care Management managers with problem solving with staffing, personnel issues, budget issues and resource management; reviews and evaluates management staff performance, initiate personnel transactions and meet hospital standard for performance evaluations.
* Supports the VP of CM with completion of financial analyses including cost of care to reimbursement, denials management, and non-reimbursed services, promoting effective resource utilization, clinical documentation/queries quality care and patient safety; oversees the Inpatient recovery process; works closely with Revenue Cycle and AHS Physician Advisors; regularly communicates with payors and/or their contracted vendors.
* Responsible for the coordination and support of the AHS Utilization Review Committee.
* Responsible of overseeing patient, physician and staff satisfaction based on quality outcomes and patient experience reporting; in conjunction with the Quality Leadership, identifies utilization issues affecting the quality of patient care.
* Provides AHS physicians, nursing and staff education including InterQual® criteria methodology, resource management, medical necessity guidelines payer sources, clinical outcome metrics, length of stay initiatives, readmission strategies, reimbursement rules and medical record documentation requirements.
* Serves as Content Expert/Liaison to community agencies, AHS and Non AHS primary care provider network and all AHS stakeholders across all AHS facilities (i.e. Nursing and Hospital Administrators) for provision of care and services across the continuum of care.
* In conjunction with department managers and/or supervisors, coordinates, develops, and implements action plans to respond to areas felt to be in need of improvement related to patient flow and care coordination across the continuum.
* Assumes accountability for improving utilization metrics associated with department/unit and meeting organizational/departmental targets.
* Evaluates, plans, and executes changes in department procedures, equipment and supplies.
* Performs all other duties as assigned.
MINIMUM QUALIFICATIONS:
* Required Education: Master's degree in Nursing or Master's degree in Social Work or related field.
* Required Experience: Seven to ten years of case management or quality experience in addition to progressive management experience in a large healthcare organization is required.
* Preferred Experience: N/A
Required Licenses/Certifications: Active licensure as a Registered Nurse in the State of California or valid license as a Clinical Social Worker issued by the State of California Board of Behavior Science Examiners; active BLS - Basic Life Support Certification issued by the American Heart Association; CPI -Crisis Prevention Intervention Training; Other advanced life support certifications may be required per unit/department specialty according to patient care policies.
Preferred Licenses/Certifications: Certification in Case Management, CCMC or ACM.
Highland General Hospital
SYS Care Coordination
Full Time
Varies
Management
FTE: 1
-
Director, Inpatient System Care Management
3 months ago
Oakland, CA, United States Alameda Health System Full timeSummary 100% employer health plan for employees and their eligible dependents Unique benefit offerings that are partially or 100% employer paid Rich and varied retirement plans and the ability to participate in multiple plans. Generous paid time off plans Role Overview: Alameda Health System is hiring! Under the direction of the Vice President of...
-
Director, Inpatient System Care Management
1 month ago
Oakland, United States Alameda Health System Full timeSummary Alameda Health System offers outstanding benefits that include: 100% employer health plan for employees and their eligible dependents Unique benefit offerings that are partially or 100% employer paid Rich and varied retirement plans and the ability to participate in multiple plans. Generous paid time off plans Role Overview: Alameda...
-
Director, Inpatient System Care Management
4 months ago
OAKLAND, United States Alameda Health System Full timeSummary Alameda Health System offers outstanding benefits that include: 100% employer health plan for employees and their eligible dependents Unique benefit offerings that are partially or 100% employer paid Rich and varied retirement plans and the ability to participate in multiple plans. Generous paid time off plans Role Overview: Alameda...
-
Director of Inpatient Care Management
4 weeks ago
Oakland, California, United States Alameda Health System Full timeJob Title: Director of Inpatient Care ManagementJob Summary:Alameda Health System is seeking a highly skilled Director of Inpatient Care Management to oversee the day-to-day operations of inpatient care management across all AHS facilities. The successful candidate will be responsible for ensuring efficient patient flow, from admission to discharge, and will...
-
Inpatient Care Manager RN
4 weeks ago
Oakland, California, United States Altais, Inc. Full timeAbout Altais, Inc.We're a mission-driven organization that's revolutionizing the healthcare system for physicians, advanced care providers, patients, and the clinical community.Our team is passionate about enabling better healthcare experiences and building breakthrough clinical support tools, technology, and services to let doctors do what they do best:...
-
Inpatient Care Manager, RN
7 days ago
Oakland, United States Altais, Inc. Full timestrong>About Our CompanyAt Altais, we're looking for bold and curious clinicians and innovators who share our passion for enabling better health care experiences and revolutionizing the healthcare system for physicians, advanced care providers, patients, and the clinical community. At Altais, we're building breakthrough clinical support tools, technology,...
-
Director, Field Medical Content
3 months ago
Oakland, CA, United States Alameda Health System Full timeSummary ~100% employer health plan for employees and their eligible dependents ~ Unique benefit offerings that are partially or 100% employer paid ~ Rich and varied retirement plans and the ability to participate in multiple plans. ~ Generous paid time off plans Role Overview: Alameda Health System is hiring! Under the direction of...
-
Manager, Care Management
5 days ago
Oakland, CA, United States Alameda Health System Full timeSummary Alameda Health System offers outstanding benefits that include: * 100% employer health plan for employees and their eligible dependents * Unique benefit offerings that are partially or 100% employer paid * Rich and varied retirement plans and the ability to participate in multiple plans. * Generous paid time off plans Role Overview: Alameda Health...
-
Manager, Care Management
3 months ago
Oakland, CA, United States Alameda Health System Full timeSummary Alameda Health System offers outstanding benefits that include: 100% employer health plan for employees and their eligible dependents Unique benefit offerings that are partially or 100% employer paid Rich and varied retirement plans and the ability to participate in multiple plans. Generous paid time off plans Role Overview: Alameda Health...
-
Manager, Care Management
3 months ago
Oakland, CA, United States Alameda Health System Full timeSummary Alameda Health System offers great benefits to our employees! 100% employer health plan for employees and their eligible dependents Unique benefit offerings that are partially or 100% employer paid Rich and varied retirement plans and the ability to participate in multiple plans. Generous paid time off plans Role Overview: The Manager of...
-
Care Management Specialist
5 days ago
Oakland, CA, United States Alameda Health System Full timeSummary SUMMARY: Assists in Care Management Team of social workers and nurses with functions such as but not limited to provide census reconciliation, administrative support for care coordination and discharge planning activities, working with the payors, accurate and critical information data entry and tracking, and report creation. DUTIES & ESSENTIAL JOB...
-
Inpatient Pharmacy Manager
2 weeks ago
Monmouth, IL, United States Clinical Management Consultants Full timeAn exceptional opening for Inpatient Pharmacy Manager is now available at a well-respected health network in gorgeous Illinois. This high-quality facility is looking for an experienced Hospital Pharmacy Manager to join their dedicated leadership team. Part of a thriving health system, this 300+ bed nonprofit community facility has national recognition for...
-
Inpatient Care Manager RN
4 weeks ago
Oakland, California, United States Altais Health Solutions Full timeAbout Altais Health SolutionsWe're a mission-driven organization that's revolutionizing the healthcare system. Our team of clinicians and innovators is passionate about enabling better healthcare experiences for physicians, advanced care providers, patients, and the clinical community.As an Inpatient Care Manager RN, you'll play a critical role in shaping...
-
Inpatient Care Manager, RN
4 weeks ago
Oakland, California, United States Altais, Inc. Full timeAbout Our CompanyAt Altais, we're a healthcare innovator, dedicated to revolutionizing the healthcare system for physicians, advanced care providers, patients, and the clinical community.We're building breakthrough clinical support tools, technology, and services to empower doctors to do what they do best: care for people.Our mission-driven organization...
-
Inpatient Care Manager, LVN
1 month ago
Oakland, California, United States Altais, Inc. Full timeAbout Our CompanyAt Altais, Inc., we're dedicated to revolutionizing the healthcare system by empowering clinicians and innovators to create better healthcare experiences. Our mission is to enable physicians, advanced care providers, patients, and the clinical community to thrive in a collaborative and supportive environment.About Your TeamWe're a...
-
Inpatient Respiratory Therapist
3 months ago
Crane, MT, United States Clinical Management Consultants Full timeAn exciting new opportunity has just become available for an Inpatient Respiratory Therapist! Join a state of the art Hospital in beautiful Eastern Montana as they are actively interviewing for a skilled Hospital Respiratory Therapist to join their Respiratory Department dedicated to top quality patient care. This well known 20+ bed Community Hospital...
-
Inpatient Hospital Pharmacist
3 months ago
Sidney, MT, United States Clinical Management Consultants Full timeAn exciting new opportunity has just become available for an Inpatient Hospital Pharmacist! Join a state of the art Hospital in beautiful Eastern Montana as they are actively interviewing for an Pharmacist to join their Pharmacy Department dedicated to top quality patient care. This well known 20+ bed Community Hospital is looking for a Pharmacist to join...
-
Manager, Care Management
1 month ago
Oakland, United States Alameda Health System Full timeSummary Alameda Health System offers outstanding benefits that include: 100% employer health plan for employees and their eligible dependents Unique benefit offerings that are partially or 100% employer paid Rich and varied retirement plans and the ability to participate in multiple plans. Generous paid time off plans Role Overview: Alameda...
-
Care Management Director
4 weeks ago
Oakland, California, United States Alameda Health System Full timeJob Summary:Alameda Health System is seeking a highly skilled and experienced professional to fill the role of Manager of Care Management. This position is responsible for overseeing the day-to-day operations of facility-wide utilization, discharge planning, and care coordination.Key Responsibilities:Assist in establishing, implementing, and ensuring that...
-
Manager, Care Management
3 weeks ago
Oakland, United States Alameda Health System Full timeSummary Alameda Health System offers outstanding benefits that include: 100% employer health plan for employees and their eligible dependents Unique benefit offerings that are partially or 100% employer paid Rich and varied retirement plans and the ability to participate in multiple plans. Generous paid time off plans Role Overview: Alameda Health...
