Director of Care Coordination Services

3 days ago

Santa Clara, California, United States The National Coalition of Healthcare Recruiters Full time
Job Summary:

The Director of Case Management leads and manages the day-to-day operations of utilization, clinical resource and case management departments and focuses on the continuum of care for the patient population.

Key Responsibilities:

  • Develops case management programs that allow the hospital(s) to meet clinical resource management goals as well as third party and regulatory standards.
  • Manages and educates staff at all levels about effective clinical resource management. Provides formal and informal programs.
  • Maintains effective working relationships and effectively communicates the goals and objectives of the program to the medical staff, department staff, and others within and outside the hospital.
  • Evaluates the effectiveness of existing clinical protocols and pathways and makes recommendations for new ones.
  • Promotes organizational mission statement and goals and empowers staff and peers to achieve outstanding performance.
  • Effectively reports departmental activities, goals, and measures of success.
  • Works effectively with MCO staff and leadership to decrease denials or downgrades in reimbursement.
  • Maintains department standards for regulatory and accreditation purposes.
  • Actively seeks to resolve those issues brought forward by medical staff that have an adverse effect on patient outcomes.
  • Analyzes the issues for cost/benefit in terms of improving clinical and financial outcomes.
  • Prioritizes and recommends effective approaches that will improve clinical and financial outcomes in the hospital.
  • Serves as the primary liaison between Case Management and the hospital Quality Committee.
  • Recommends plans of care for high profile DRGs that incorporate effective Case Management strategies.
Requirements:
  • 5+ years experience in a health care facility
  • At least 2+ years Nursing Management experience in an acute care setting required
  • Hospital Case Management experience required
  • Managed Care Organization (MCO) experience preferred
Education:

Master's Degree in Nursing or a related healthcare field required

Certifications/Licensures:
  • Registered Nurse License required
  • Certified Case Manager (CCM) a plus, not required
  • Healthcare Quality of Utilization Review (HQUR) a plus, not required
Special Skills:
  • Advanced communication and interpersonal skills
  • Analytical and quantitative analysis skills
  • Ability to lead a complex department to reach and exceed goals
  • Ability to work with other departments
  • Knowledge of Managed care trends, Medicare and Medicaid regulations

  • Program Director

    5 days ago

    Santa Clara, California, United States LifeMoves Full time

    Job SummaryLifeMoves is seeking a highly skilled and compassionate Program Director to oversee our homeless services programs. As a key member of our team, you will be responsible for delivering high-quality services to our clients, managing staff, and ensuring the effective operation of our programs.Key ResponsibilitiesProgram Management: Oversee the...

  • Executive Director

    1 day ago

    Santa Clara, California, United States Claire Myers Consulting Full time

    About Our ClientClaire Myers Consulting is a professional services firm dedicated to enhancing the quality of life for older adults in their community. We provide a range of services that support independence, dignity, and connection. Our mission is to ensure that seniors live fulfilling lives, and we are looking for a passionate leader to guide us in this...

  • Director of Physical Therapy Services

    1 week ago

    Santa Clara, California, United States Concentra Full time

    Physical Therapy Director Opportunity at ConcentraWe are seeking a highly skilled and experienced Physical Therapy Director to join our team at Concentra, a leading provider of occupational medicine services. As a key member of our patient care team, you will play a vital role in delivering exceptional care to our patients.Key Responsibilities:Leadership and...

  • Caregiver/Home Care Aide

    7 days ago

    Santa Clara, California, United States Care America Homecare Services Full time

    Care America Homecare Services is a leading provider of home and community-based services, seeking compassionate and dedicated professionals to join our team of caregivers.We offer a rewarding career opportunity with a focus on providing assistance with the activities of daily living and companionship to seniors, disabled individuals, and others in need.Our...

  • Client Services Coordinator for the CARE Office

    7 days ago

    Santa Cruz, California, United States University of California Santa Cruz Full time

    Job SummaryThe Intake and Administrative Coordinator for the Center for Advocacy, Resources, and Empowerment (CARE) plays a crucial role in supporting the Director and the CARE team. The incumbent will be responsible for screening clients upon initial contact with CARE, assigning them to the appropriate advocate, and providing administrative support to the...

  • Director of Dining Services

    1 week ago

    Santa Clara, California, United States Compass Group Careers Full time

    Job SummaryJob Title: Director of Dining ServicesJob Type: Full-timeIndustry: Foodservice, HospitalityCompany: Compass Group CareersLocation: NationwideJob Description:Key ResponsibilitiesOversee Foodservice Operations: Manage and lead a team of employees to ensure seamless foodservice operations, including menu planning, inventory management, and food...

  • Sales and Service Coordinator

    1 month ago

    Santa Clara, California, United States Sephora Full time

    Job ID: 253409Store Name/Number: CA-Valley Fair (0018)Address: 2855 Stevens Creek Blvd., Suite #1067, Santa Clara, CA 95050, United States (US)Hourly/Salaried: Hourly (Non-Exempt)Full Time/Part Time: Full TimePosition Type: RegularYour Role at Sephora: As a Sales and Service Coordinator, you'll be a key player in our mission to provide an exceptional...

  • Critical Care Travel Nurse

    2 weeks ago

    Santa Clara, California, United States TheraEX Staffing Services Full time

    Job SummaryTheraEX Staffing Services is seeking a skilled travel nurse to join our team in a critical care setting. As a travel nurse, you will have the opportunity to work in a dynamic and challenging environment, providing high-quality patient care and collaborating with a multidisciplinary team.Key ResponsibilitiesProvide direct patient care to critically...

  • Critical Care Travel Nurse

    1 week ago

    Santa Clara, California, United States TheraEX Staffing Services Full time

    Job SummaryTheraEX Staffing Services is seeking a skilled travel nurse to join our team in a critical care setting. As a travel nurse, you will have the opportunity to work in a dynamic and challenging environment, providing high-quality patient care and collaborating with a multidisciplinary team.Key ResponsibilitiesProvide direct patient care to critically...

  • Physician - Director for Primary Care (Community Based Outpatient Clinic)

    3 months ago

    Santa Rosa, California, United States Department Of Veterans Affairs Full time

    SummaryThis position is eligible for the Education Debt Reduction Program (EDRP), a student loan payment reimbursement program. You must meet specific individual eligibility requirements in accordance with VHA policy and submit your EDRP application within four months of appointment. Approval, award amount (up to $200,000) and eligibility period (one to five...

  • Licensing Program Analyst

    2 days ago

    Santa Clara, California, United States Department of Social Services Full time

    Job SummaryThe Department of Social Services is seeking a highly skilled and detail-oriented Licensing Program Analyst to join our team. As a key member of our Child Care Licensing Program, you will be responsible for a full range of licensing duties, including developing and implementing orientations and training programs, reviewing applications,...

  • Project Coordinator

    2 weeks ago

    Santa Clara, California, United States Collabera Full time

    Job Title: Project Coordinator | Program DirectorDuration: 12 monthsLocation: RemotePay Range: Competitive salaryDescription:We are seeking a highly skilled Project Coordinator with 8-10 years of demonstrated expertise in a fast-paced Project and Program Management setting. The ideal candidate will have prior experience as a Business Data Analyst, which is...

  • Corporate Partnerships and Community Engagement Coordinator

    4 days ago

    Santa Clara, California, United States LifeMoves Full time

    About the RoleWe are seeking a highly skilled and experienced Corporate Partnerships and Community Engagement Coordinator to join our team at LifeMoves. As a key member of our Corporate and Community Engagement (CCE) Team, you will play a critical role in cultivating and stewarding relationships with corporate and community partners to further our...

  • Primary Care Nurse Practitioner

    7 days ago

    Santa Clara, California, United States Crossover Health Management Services Inc. Full time

    About Crossover Health Management Services Inc.Crossover Health Management Services Inc. is revolutionizing the healthcare industry by providing a comprehensive and proactive approach to patient care. Our team-based medical group focuses on prevention and wellbeing, extending beyond traditional sick care to deliver a new model of healthcare.Job SummaryThe...

  • Hospice Care Coordinator

    7 days ago

    Santa Clarita, California, United States Vertex Hospice Care Inc Full time

    Job SummaryVertex Hospice Care Inc is seeking a dedicated and compassionate Hospice Patient Coordinator to join our team. As a key member of our care team, you will play a vital role in coordinating patient care and services, ensuring seamless communication and collaboration with our team, social workers, home health aides, and...

  • Clinical Director of Primary Care Services

    7 days ago

    Santa Cruz, California, United States Discover Vanderbilt University Medical Center Full time

    Job SummaryThe Associate Medical Director of Clinical Operations is a key member of the University of California, Santa Cruz Student Health Services Management Team. This role is responsible for ensuring that issues affecting clinical practice, quality of care, staffing, and clinician job satisfaction are appropriately managed in our Primary Care and Same...

  • Executive Director of Operations

    5 days ago

    Santa Clara, California, United States Resiliency Full time

    Job Description:We're seeking a highly skilled Executive Director of Operations to join our team at Resiliency. As a key stakeholder, you will play a crucial role in ensuring customer satisfaction, leading company guidelines and processes, and driving company profitability.The successful candidate will:Work closely with the Distribution Manager, Warehouse,...

  • Human Resources Coordinator

    3 months ago

    Santa Clara, California, United States Aston Carter Full time

    Description:Medical Device company in the South Bay is hiring a HR Coordinator This HR coordinator will be supporting the Director of HR operations with interview scheduling, meeting planning (setting up for company events for people), HRIS tracking, data entry of employee information when changing departments, LOA tracking, supporting the SOX audits and...

  • Facilities and Office Services Coordinator

    2 weeks ago

    Santa Clara, California, United States The Millennium Group Full time

    Job OverviewWe are seeking a dedicated Facilities and Office Services Coordinator to join our team at The Millennium Group. This role is essential in ensuring the smooth operation of our office environment.Key Responsibilities:Receive and securely screen all incoming deliveries, ensuring accurate counting and verification.Maintain a detailed log of all...

  • Clinical Director of Primary Care

    7 days ago

    Santa Cruz, California, United States University of California Santa Cruz Full time

    About the RoleThe University of California Santa Cruz is seeking an experienced and skilled medical professional to fill the position of Associate Medical Director of Student Health Services. As a key member of the Clinical Services Management and Primary Care Leadership Teams, the successful candidate will be responsible for ensuring the smooth operation of...