Sr Spec-Integrated Care Mgmt - Utilization Management - Sharp Corporate - FT - Days

Sharp HealthCare • San Diego, CA

4d • $67 - $97

About The Position

The Sr Specialist Integrated Care Management is a key member of the Integrated Care Management (ICM) leadership team, responsible for advancing high-quality, patient-centered care through expert oversight of ICM practices. This role supports the daily operations of assigned areas and plays a central role in driving clinical excellence, regulatory compliance, and operational efficiency. In close collaboration with interdisciplinary care teams, site and system leadership, and senior leaders, the Sr Specialist provides expert consultation on complex and escalated cases. The role also leads coaching and education efforts, facilitates process improvement initiatives, and ensures adherence to organizational and regulatory standards. As a clinical leader, the Sr Specialist serves as a trusted mentor and resource for ICM team members, physicians, students, and staff pursuing professional certifications. This role is a change agent with a high degree of expertise. The Sr Specialist Integrated Care Management plays a vital role in advancing the mission of delivering the highest quality care with a commitment to continuous improvement.

Requirements

• Bachelor's Degree in Nursing
• 3 Years acute care or clinical experience in area of specialty.
• California Registered Nurse (RN) - CA Board of Registered Nursing
• Accredited Case Manager (ACM) - American Case Management Association (ACMA) OR Certified Case Manager (CCM) - Commission for Case Manager Certification - Required within 1 year of hire. Department will track and maintain this certification. For Sr Spec ICM assigned to Utilization Management, Train-the-Trainer certification may substitute for ACM or CCM.

Nice To Haves

• Master's Degree in Nursing
• Master's Degree in a healthcare related field.
• Accredited Case Manager (ACM) - American Case Management Association (ACMA) -PREFERRED
• Certified Case Manager (CCM) - Commission for Case Manager Certification -PREFERRED

Responsibilities

• Collaboration and Teamwork Provides Sr. Specialist Inpatient Care Management support for ICM programs, initiatives, and community partnerships. Demonstrate team behaviors with a commitment to quality. Develop/foster peer relationships that promote efficient integrated departmental operations. Demonstrated ability to multi-task and drive change within the ICM Division at the site level. Ability to take vision from the System ICM leadership team and translate that vision into practical and manageable ICM workflows with a focus on consistency and standardization. Key resource to assist with and assume as indicated complex cases to support facility LOS goals.
• Communication Actively contributes to the ICM Leadership team by bringing creative thinking and innovation to assist in enhancing overall patient care and operational efficiencies. Advanced communication skills as demonstrated by abilities to: 1. Act as a subject matter expert and resource for the social work team and other members of the IDT. 2. Develop quick and sustainable rapport with complex patients. 3. Bring together often diverse internal and external conflicting stakeholders to a common consensus and care plan. 4. Identify, partner in the development of and implement programs to address educational gaps. Establish effective working relationships between internal and external customers with a focus on efficiency and superior outcomes. Partner with System and Regional/Metro Market ICM site leadership to ensure timely communication and facilitation of communications to ensure optimal operations. Deliver answers and solutions within the agreed upon timeframe.
• Financial Accountability Take initiative in using time effectively and assists team to manage time effectively. Seek to improve systems and processes that ultimately improve staff performance and assist in reducing the overall cost of care in collaboration with other members of the ICM Leadership team.
• Human Resource Management Support site ICM Leadership in new team member onboarding. Provide coaching to team members as directed. Support department operations as directed.
• Leadership Serves as an informal member of the ICM Leadership team. Actively participate in ICM team and leadership meetings. Demonstrates creative and effective problem solving/critical thinking skills. Works with the Inpatient Care Management team members to achieve departmental and system goals.
• Professional Development Establish mutually derived annual goals and meets goals. Maintain individual in-service/performance records. Ongoing professional growth through attendance at educational forums as identified to support the roles and responsibilities of this position.
• Quality and Safety Partners with the System ICM Quality and Regulatory Specialists and System ICM Educators to drive change and standardization. Takes audit findings and works with identified team members to create action plans and reports back to the System ICM and Site leadership. Identify, drives and/or participates in initiatives to improve work processes with focus on superior outcomes. Actively practices safe work habits and contribute to ensuring a safe work environment. Utilizes appropriate processes or tools to document identified problems. Make sound decisions and demonstrates ability to handle complex situations not covered by written or verbal instructions. Escalate cases and situations to the appropriate resources timely when issues or problems arise.
• Clinical Competency Accredited Case Manager (ACM) - American Case Management Association (ACMA) OR Certified Case Manager (CCM) - Commission for Case Manager Certification - Required within 1 year of hire. Department will track and maintain this certification. For Sr Spec ICM assigned to Utilization Management, Train-the-Trainer certification may substitute for ACM or CCM.
• Knowledge, Skills, and Abilities Proficiency with information systems and computer programs such as word, excel, powerpoint, etc. Skilled in conflict management and resolution. Demonstrated superior communication and critical thinking skills. Self-directed and demonstrates ability to prioritize. Demonstrated ability to remain flexible in a rapidly changing environment and current health care dynamic climate. Works collaboratively with interdisciplinary team.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Number of Employees: 5,001-10,000 employees