Care Management Director
2 weeks ago
Job Summary:
Alameda Health System is seeking a highly skilled and experienced Manager, Care Management to lead our care coordination efforts. As a key member of our team, you will be responsible for overseeing the day-to-day operations of utilization management, care coordination, and discharge planning activities.
Key Responsibilities:
- Develop and implement care management policies, practices, and procedures in accordance with regulatory agencies and hospital policies.
- Conduct staff meetings and interdepartmental team conferences to identify and address utilization issues.
- Develop and provide statistical reports to inform quality improvement initiatives.
- Manage the process of pre-admission review and offer solutions to improve patient flow and care coordination.
- Oversee the submission of audits and appeals to ensure minimal denial rates.
- Perform daily clinical rounds and monthly audits to ensure compliance with care management standards.
- Prepare cost analysis reports and other data needed for budget preparation.
- Provide educational programs for staff and physicians to enhance care management knowledge and skills.
- Recruit, orient, evaluate, counsel, and discipline care management clinical and administrative staff.
Requirements:
Preferred Licenses/Certifications: Certification in Case Management, CCMC or ACM.
Preferred Education: Master's in Nursing or Masters in Social Work or related field.
Required Experience: Five years of clinical nursing or social work experience in a directly related setting; three years of case management experience; two years of experience in a supervisory or lead role.
Required Licenses/Certifications: Active licensure as a Registered Nurse in the State of California or licensed in Clinical Social Work in California, Active BLS - Basic Life Support Certification issued by the American Heart Association.
About Alameda Health System:
Alameda Health System is a leading healthcare provider in the Bay Area, committed to delivering high-quality patient care and exceptional service. We offer a comprehensive benefits package, rich retirement plans, and opportunities for professional growth and development.
How to Apply:
Interested candidates should submit their application, including a cover letter and resume, to [insert contact information].
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