Care Management Manager
2 weeks ago
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.
- 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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