Care Management Manager

2 weeks ago


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

Alameda Health System is seeking a highly skilled Care Management Manager to oversee the day-to-day operations of facility-wide utilization, discharge planning, and care coordination.

Key Responsibilities:
  • Assist in establishing, implementing, and ensuring that care management policies, practices, and procedures are in accordance with regulatory agencies and hospital policies.
  • Conduct and record periodic staff meetings to inform staff of changes in policies and procedures.
  • Develop and provide statistical UM information and reports to appropriate committees.
  • Direct and coordinate data gathering and record keeping legally required by Federal and State agencies.
  • Manage and assume responsibility for day-to-day operations of utilization management, care coordination, and discharge planning activities.
  • Oversee submission of audits, including but not limited to MediCal, Medicare, and internal compliance studies.
  • Perform daily clinical rounds and monthly audit of charts on care management activities.
  • Prepare cost analysis reports and other data needed for the preparation of the departmental budget.
  • Provide in-house educational programs as needed for both staff and physicians.
  • Responsible for the recruitment, orientation, evaluation, counseling, and disciplinary action of 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.
  • 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.

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