Care Management Director
2 weeks ago
Alameda Health System is seeking a highly skilled and experienced Manager, Care Management to lead our care management team. The successful candidate will be responsible for the day-to-day operations of facility-wide utilization, discharge planning, and care coordination.
Key Responsibilities:- Assist in the development and implementation of care management policies, practices, and procedures in accordance with regulatory agencies and hospital policies.
- Conduct regular staff meetings to inform staff of changes in policies and procedures.
- Collaborate with interdepartmental teams to identify aberrant utilization and develop strategies to address it.
- Develop and provide statistical utilization management information and reports to appropriate committees.
- Direct and coordinate data gathering and record keeping required by regulatory agencies and hospital policies.
- Manage the day-to-day operations of utilization management, care coordination, and discharge planning activities.
- Oversee the submission of audits and appeals for denied cases.
- Perform daily clinical rounds and monthly audits 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 for staff and physicians.
- Recruit, orient, evaluate, counsel, and discipline care management clinical and administrative staff.
- Responsible for purchasing, educating, and recording education on new equipment and techniques.
- Review cases regularly with staff and act as a clinical consultant on care management issues.
- Serve as a content expert to staff and internal departments and external partners.
- 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.
- 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.
Alameda Health System is an equal opportunity employer and does not discriminate against any employee or applicant for employment based on race, color, religion, national origin, age, gender, sex, ancestry, citizenship status, mental or physical disability, genetic information, sexual orientation, veteran status, or military background.
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