Care Management Director

2 weeks ago


Oakland, California, United States Alameda Health System Full time
Job Title: Manager, Care Management

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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