Director, Case Management
Company: Care Navigators On Demand
Location: Gardena
Posted on: January 26, 2023
Job Description:
Full time - Care Navigators On Demand - United States Posted On
08/21/2019 Job Information Industry Health Care City State/Province
California Zip/Postal Code 90501 Job Description Job
Duties:
- Provides leadership and management of clinical care
coordination, utilization management, discharge planning, and
outcomes management.
- Oversees the MediCal TAR process...
- Manages the systems, processes, and outcomes of clinical care
teams and programs designed to address clinical and financial needs
of patients and families.
- Responsible for goal setting, program planning, work flow
processes, regulatory compliance, staff productivity, facilitation
of work teams, quality of work, outcome evaluation and continuous
quality improvement.
- Represents the hospital to internal and external customers,
including patients and families, physicians, service line
leadership, administration, and health plans.
- Maintains professional and collaborative relationships with the
hospital administration, staff, physicians, service line
administration, other internal and external customers, including
health plans, medical groups, patients and families.
- Develops and maintains a positive working relationship with the
Physician Advisor of the facility to ensure correct patient
classifications, timely denials management, and development of
collaboration with physician members and other departmental leaders
within the hospital.
- Participates in Utilization Review Committee
functions.
- Knowledge of State and Federal Regulations including but not
limited to EMTALA, MediCal, Medicare, and HMO's.
- Contributes toward effective, positive working relationships
with internal and external colleagues.
- Demonstrates cooperation, flexibility, reliability and
dependability in all daily work activities.
- Demonstrates a willingness to collaborate with others for the
good of the customer and the organization.
Job Requirements
Knowledge, Skills, Abilities
- Knowledge of the theory, principles, and practices of case
management and social services.
- Knowledge of patient rights.
- Knowledge of principles and practices of management and
supervision including planning, organizing, directing, motivating,
controlling and decision making.
- Ability to communicate effectively with individuals at all
levels and from all backgrounds both orally and written.
- Ability to set priorities appropriately and handle multiple
issues concurrently.
- Ability to establish and monitor departmental and corporate
goals.
- Ability to motivate subordinates to work effectively and
efficiently.
- Possess strong critical thinking skills with the ability to
work independently as well as in teams.
Education/Experience
- Baccalaureate in Nursing strongly preferred. Master's degree a
strong plus.
- Minimum of three years in acute care Case Management preferably
in a leadership role.
- Valid RN License in the State of California.
- Current BLS Card issued by the American Heart
Association.
- ACM preferred.
- McKesson InterQual experience preferred.
ADA/Physical Demands
- To perform this job successfully, and individual must be able
to perform each essential job duty satisfactorily. The requirements
listed are representative of the knowledge, skill and ability
required. Reasonable accommodation may be made to enable
individuals with disabilities to perform the essential functions.
Such accommodations must be requested by the employee/applicant in
order to be considered.
- Required to stand; walk; sit; use hands to fingers, handle, or
feel; reach with hands and arms; stoop, kneel, crouch or crawl;
talk and hear; and may taste and smell. The employee is regularly
required to lift, push and or pull weights in excess of 10 pounds
with assistance. Visual abilities, auditory abilities must be
intact to perform duties.
Requirements Education/Experience
- Baccalaureate in Nursing strongly preferred. Master's degree a
strong plus.
- Minimum of three years in acute care Case Management preferably
in a leadership role.
- Valid RN License in the State of California.
- Current BLS Card issued by the American Heart
Association.
- ACM preferred.
- McKesson InterQual experience preferred.
Care Navigators On Demand is an Equal Opportunity Employer and does
not discriminate on the basis of race or ethnicity, religion, sex,
national origin, age, veteran disability or genetic information or
any other reason prohibited by law in employment.
Keywords: Care Navigators On Demand, Gardena , Director, Case Management, Executive , Gardena, California
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