Care Management Manager : Clinic Care Management

Hoag • Newport Beach, CA

3d

About The Position

The Manager of Care Management is responsible for the daily oversight and management of inpatient and care management staff. This position must support concurrent, retrospective inpatient review, discharge planning, transitional care and care management programs for Hoag MG and IPA assigned membership. They are responsible for helping to develop and implement any necessary P&P’s and workflow to ensure consistency, effectiveness and efficiency in the use of all resources required to accomplish all department goals and objectives. They will identify any opportunities for and implement any changes necessary to improve upon workflows and department performance that will ensure a high level of satisfaction with our customers and compliance with all Federal, State and Health Plan requirements. They will monitor the department performance against these requirements. They will be a resource to staff for addressing difficult issues that arise within the department. Interface with Medical Directors, hospitalists, physicians, other department leaders and vendors as needed.

Requirements

• Current RN license in the State of California
• BSN or Bachelor Degree in Health Care related field
• Minimum of 2 years of supervisory experience in a medical group or health plan setting
• At least two years of experience with Inpatient Case Management and/or Outpatient Care Management
• Understanding of nationally recognized criteria (Milliman Care Guidelines/Interqual/CMS, etc.)
• Fulfills mandatory stroke education requirements per certification agency
• Active unrestricted RN license in the State of California

Responsibilities

• Daily oversight and management of inpatient and care management staff.
• Support concurrent, retrospective inpatient review, discharge planning, transitional care and care management programs.
• Develop and implement necessary P&P's and workflow for consistency, effectiveness, and efficiency.
• Identify opportunities and implement changes to improve workflows and department performance.
• Ensure high customer satisfaction and compliance with Federal, State, and Health Plan requirements.
• Monitor department performance against requirements.
• Serve as a resource to staff for addressing difficult issues.
• Interface with Medical Directors, hospitalists, physicians, other department leaders, and vendors.

What This Job Offers

• Job Type: Full-time
• Career Level: Manager