Manager Case Management - SAC 22-86

Company: PriMed Management Consulting Services, Inc.
Location: Sacramento
Posted on: May 26, 2023

Job Description:

Manager Case Management - SAC 22-86 page is loaded Manager Case Management - SAC 22-86 Apply locations Sacramento, California time type Full time posted on Posted 22 Days Ago job requisition id R1575 We're delighted you're considering joining us!At Hill Physicians Medical Group, we're shaping the healthcare of the future: actively managed care that prevents disease, supports those with chronic conditions and anticipates the needs of our members.Join Our TeamHill Physicians -has much to offer prospective employees. We're regularly recognized as one of the "Best Places to Work in the Bay Area" and have been recognized as one of the "Healthiest Places to Work in the Bay Area." When you join our team, you're making a great choice for your professional career and your personal satisfaction.Perform highly responsible management work in leading, developing, directing, and coordinating programs and functional activities for post-discharge/Welcome Home and case management teams for all lines of business including Medicare, Medi-Cal, HMO, and PPO. -
Ensure corporate utilization management goals around readmissions and ER visits are met through member care coordination initiatives and identify and oversee implementation of process changes as needed to meet these goals.Job Responsibilities

• Provide case management direction to the functional areas of welcome home and complex case management to achieve annual department, corporate and ICE goals.
• Provide oversight to supervisors carrying out staff responsibilities; interpret policies, operational procedures, and department objectives.
• Collaborate with the Care Management Advisor Responsible for annual review, modifications, and submission of the Case Management Program Description.
• Oversee Case Management and Welcome Home staff and manage relevant care coordination strategies: production TAT's, welcome home program, video visits uptake, medication reconciliations post-discharge, provider follow-up appointments scheduled within 7 days, and enrollment of highest risk members in complex case management.
• Provide direction and support staff to promote good decision-making in area of responsibility, utilizing information analysis of factors related to Hill Physician's goals of admissions, readmissions, ER and other strategies.
• In collaboration with Department Senior Director, apply Human Resources/Personnel policies according to organizational procedure and serve as a resource for the implementation of such policies and procedures; define expectations for performance and hold subordinates accountable; set goals and outcome parameters and define operational parameters and expectations. -
• Interview, hire, and conduct performance evaluations for each of the positions directly accountable to the position; act as a resource to department supervisors in completion of performance evaluations.
• In collaboration with department director, participate in the organization's budget planning process; organize the budget planning process in assigned area of responsibility; monitor and analyze budget variance.
• Assist Regional and Corporate Medical Director functions. Serve as a resource for physicians, providers, members, and staff; participate on assigned committees; promote effective communication; act as liaison to other departments, the medical staff, and health plans to facilitate information-sharing, collaborative problem solving, and adequate provision of support services.
• Assure that department functions are integrated appropriately into company operations.
• Collect, analyze, evaluate, and present clinical management data to internal and external leadership; perform operations analysis with appropriate follow-up action plan and intervention.
• Establish planning processes in response to corporate strategy, goals, and objectives; monitor progress and accomplishments on a regular basis; promote and coordinate case management initiatives and program development through appropriate planning, analysis, and developmental phases.
• Review department performance in relation to established goals; implement changes to effect continual improvement in services provided; and ensure compliance with regulatory and legal requirements.
• Supervise the administration of Medical Management Teams and support organization clinical initiatives.
• Represent Case Management Department on inter-departmental committees as appropriate.
• Collaborate with administration, management, and educational resources to develop mechanisms for educational advancement; facilitate methods for appropriate professional development in an effort to assure competency in assigned area of responsibility; plan strategy for development and ongoing educational needs; serve as mentor (coach and counsel) promoting professionalism on a group or individual basis.
• Other duties as assigned.Required Experience
  • Active unrestricted CA RN license.
  • Recent CM experience strongly preferred.
  • Minimum of five years management experience, preferably two years in managed care environment.
  • Strong computer skills, including Microsoft Office Suite applications.
  • Excellent leadership, organizational, communication and presentation skills.
  • Self-motivated with the ability to work independently.Required Education
    • Bachelor's degree in nursing or health related field; Master's degree preferred.
    • Case Management certification (CCM) strongly preferred.Salary Range$118,500.00 - $147,100.00Additional InformationHill Physicians is an Equal Opportunity Employer About Us PriMed Management Consulting Services, Inc., is the management services organization for Hill Physicians Medical Group, the largest Independent Physician Association (IPA) in Northern California.More than just a job - We're making a meaningful contribution to healthcare.Everyone at PriMed contributes to making quality healthcare accessible for Northern Californians. We have a unique collection of skilled professionals that work well together and have been recognized as one of the top places to work and one of the healthiest places to work in the Bay area. -

Keywords: PriMed Management Consulting Services, Inc., Sacramento , Manager Case Management - SAC 22-86, Executive , Sacramento, California