Sutter Health Manager, Care Coordination - Mission Bernal Campus in San Francisco, California
The Care Coordination (CC) Manager is to assist the Director in managing the overall operations of the Care Coordination department for Sutter Health entities in accordance with current Federal and state regulations and guidelines. The Care Coordination Manager works in collaboration with the Director and VP of Care Management to manage and implement the strategic plan for the Care Coordination departments as assigned. The Care Coordination Manager collaborates with the Utilization Management Physician Advisor /or Medical Director. The Care Coordination Manager reports to the Care Coordination Director. Reporting to this position are RN Case Managers Case, Management Assistants and/or Social Workers and other support staff as determined by the Director. The Manager of Care Coordination has frequent contact with the Administrative Team, Nurse Executive and Directors, Quality Directors, Ancillary Services Directors, Claims and Finance Department leaders, Medical Directors, Medical Staff leaders, physicians, payers and review agencies, contracted providers and community resources as well as contact with patients/families.
BS in Nursing or Health Administration required
MS in Nursing, Case Management, or related field desired
CA RN current license required
National Certification in Case Management (ACM, ANA RN-BC Case Management) within 18 months of hire
Experience leading innovative case management programs.
Strong problem resolution abilities and customer relation skills
Experience planning, leading and organizing the resources of a team preferred.
Experience in patient care or health education in variety of settings preferred.
Experience in utilization management and discharge planning required.
Leadership experience in acute case management required.
Experience with clinical assessment for clients with complex medical, emotional and social needs.
Experience in coordinating UM Committees/and or Clinical Review teams.
Experience coaching, counseling and administering corrective action.
Knowledge of ACMA, CMSA, and NASW Standards of Practice.
Knowledge of available health care and community resources
A broad knowledge base of health care delivery and case management within a managed care environment.
Comprehensive knowledge of laws, regulations and professional standards affecting case management practice in an integrated delivery system: including but not limited to: CMS, Title 22, CHA Consent Manual, and TJC.
Excellent verbal and written communication skills.
Group presentation design and facilitation skills.
Demonstrated ability to develop and manage complex projects.
Working knowledge of Inter-Qual criteria.
Working knowledge of MIDAS and experience with an E.H.R. (EPIC preferred)
Ability to promote teamwork and to effectively function in teams, both as a leader and as a team member.
Ability to interact effectively with key internal and external constituents using collaboration, negotiation and analytical problem resolution skills.
Effective human relations and interpersonal skills necessary to lead the efforts of diverse health professionals to meet program objectives.
Ability to work effectively in a fast paced environment, directing services at multiple locations.
Analytical and mathematical skills.
Demonstrated ability to implement continuous quality improvement processes and techniques, including benchmarking and outcomes measurements.PC skills, word processing, spreadsheets and managed care software programs.
Organization: California Pacific Medical Center
Employee Status: Regular
Employee Referral Bonus: No
Position Status: Exempt
Job Shift: Day
Shift Hours: 8 Hour Shift
Days of the Week Scheduled: Monday-Friday
Weekend Requirements: Other
Schedule: Full Time
Hrs Per 2wk Pay Period: 80
All qualified applicants will receive consideration for employment without regard to race, color, creed, religion, marital status, sexual orientation, registered domestic partner status, sex, gender, gender identity or expression, ancestry, national origin (including possession of a driver's license issued to individuals who did not present proof of authorized presence in the U.S.), age, medical condition, physical or mental disability, military or protected veteran status, political affiliation, pregnancy or perceived pregnancy, childbirth, breastfeeding or related medical condition, genetic information or any other characteristic made unlawful by local, state, or federal law, ordinance or regulation. External hires must pass a background check/drug screening. Qualified applicants with arrest and/or conviction records will be considered for employment in a manner consistent with Federal, state, and local laws, including but not limited to the San Francisco Fair Chance Ordinance.