Pediatric Nurse, Lead

SAN JOAQUIN COUNTY HEALTH COMMISSION•Modesto, CA

20d•Remote

About The Position

We are currently hiring a Pediatric Nurse, Lead to join our team! This position is remote eligible; Candidates must reside in California. What You Will Be Doing: Responsible for achieving overall clinical performance goals through day-to-day direction of the designated clinical care team, coordinating operational processes, monitoring performance to achieve consistent process standards and metrics through quality assessments, training, and improvement tactics, and in compliance with regulatory and NCAA accreditation standards. Our Vision: Continuously improve the health of our community. Our Mission: We provide healthcare value and advance wellness through community partnerships.

Requirements

Produces work that is accurate and complete.
Produces the appropriate amount of work.
Actively learns through experimentation when tackling new problems, using both successes and failures to learn.
Rebounds from setbacks and adversity when facing difficult situations.
Knows the most effective and efficient process to get things done, with a focus on continuous improvement.
Self-motivated with effective critical thinking skills.
Strong oral and written communication skills.
Strong customer service skills.
Time management and organizational skills. Uses time effectively and efficiently. Values time. Concentrates his/her efforts on the more important priorities. Can attend to a broader range of activities. Meets deadlines.
Strong ethics and high level of personal and professional integrity.
Computer literate and highly proficient in using MS office programs.
Interpersonal skills - interacts effectively with individuals both inside and outside of HPSJ; relates openly and comfortably with diverse groups of people.
Strong ethics and high level of personal and professional integrity.
Ability to direct clearly and in an organized pattern
Ability to promote learning and self-empowerment in associates.
Computer literate and highly proficient in using MS office program
Associate degree in nursing.
Current and valid, unrestricted California state RN nursing license.
Valid Driver Licenses with no driving restrictions.

Nice To Haves

Baccalaureate Degree in Nursing.
Minimum two years acute clinical experience; two years experiencing in utilization management in health plan, medical group or IPA setting is preferred.
Utilization Management experience with MCG Criteria.
Current Certified Case Manager (CCM) Preferred.

Responsibilities

In a partnership with the Inpatient Supervisor, leads the Pediatric team and provides day to day oversight of team functions to meet all regulatory guidelines and company initiatives for CCS and pediatric cases.
Works in collaboration with the supervisor to identify and implement consistent work processes to achieve compliance standards and continuous operational readiness in accordance with NCQA accreditation and State regulations.
Monitors daily workflow including incoming referrals, case load and acuity management to meet production standards and to achieve compliance standards according to regulatory guidelines and company initiatives for CCS and Pediatric cases.
Independently oversees and advises the correct application of methodology and outcomes monitoring and reporting for members eligible for the CCS program.
Provides subject matter expertise to staff.
Utilizes clinical knowledge to apply evidence- based practice guidelines and criteria.
Conducts and records both focused and standard QI audits in collaboration with Supervisor. Provides feedback for team members and the management team.
Tracks and trends performance, identifies root causes, and reports and recommends improvement opportunities to management, based on audit results.
Coaches, trains, and conducts follow up for team performance improvement.
Collaboration with the Superior to identify, design and deliver training modules to promote improved performance and/or implement new regulatory guidelines pertinent to pediatric programs.
Carries caseload, as assigned by the Supervisor; and provides coverage as needed.
Acts as subject matter expert and participated in the training of new clinical personnel.
Maintains the Unit’s Training Manual and Desktop Procedures (Job Aids).
Regular and consistent attendance.

Benefits

Competitive salary
Robust and affordable health/dental/vision with choices in providers
Generous paid time off (starting at 3 weeks of PTO, 4 paid floating holidays including employee’s birthday, and 9 paid holidays)
CalPERS retirement pension program, automatic employer-paid retirements contributions, in addition to voluntary defined contribution plan
Two flexible spending accounts (FSAs)
Employer-Paid Term Life and AD&D Insurance
Employer-Paid Disability Insurance
Employer-Paid Life Assistance Program
Health Advocacy
Supplemental medical, legal, identity theft protection
Access to exclusive discount mall
Education and training reimbursement in addition to employer-paid elective learning courses.
A chance to work for an organization that is mission-driven – our members and community are at the core of everything we do.
A shorter commute – if you’re commuting from the Central Valley to the Bay Area.
Visibility and variety – you have a chance to work with people at all levels of the organization, and work on diverse projects.