SanLeandroRecruiter Since 2001
the smart solution for San Leandro jobs

SLH Manager, Care Management

Company: Alameda Health System
Location: San Leandro
Posted on: January 11, 2021

Job Description:

Summary JOB SUMMARY: San Leandro hospital is seeking a highly skilled Manager of Care Management. We are seeking an RN with experience in Care Management. This Manager will need to have experience within hospital case management that is recent. In this role you will be responsible for direct report management and overseeing the day to day operations.DUTIES & ESSENTIAL JOB FUNCTIONS: NOTE: The following are the duties performed by employees in this classification; however, employees may perform other related duties at an equivalent level. Not all duties listed are necessarily performed by each individual in the classification.* Manages and assumes responsibility for day to day operations of utilization management, care coordination and discharge planning activities* Responsible for the recruitment, orientation, evaluation, counseling and disciplinary action of care management clinical and administrative staff* Reviews cases regularly with staff; acts as clinical consultant regarding care management issues; guides clinical staff with review of assessments and care plans, evaluates utilization reviews or documentation* Serves as a content expert to staff and internal departments and external partners; networks with other hospitals, nursing organizations, and professional organizations to keep abreast of changes within the profession* Oversees submission of any audits, including but not limited to MediCal, Medicare and internal compliance studies* Performs daily clinical rounds and monthly audit of charts on care management activities (utilization review, discharge planning and Interpreter Reliability* Conducts interdepartmental team conferences for identifying aberrant utilization; establishes a method of tracking variances based on critical timelines* Assists Director in establishing, implementing and ensuring that care management policies, practices and procedures are in accordance with the Joint Commission, Title 22 and other regulatory agencies and overall hospital policies* Direct and coordinate data gathering and record keeping legally required by Federal and State agencies, the Joint Commission, and hospital policies; participates in the risk mitigation, process of implementing new or revised processes, and projects* Manages process of pre-admission review of questionable admissions as referred by Admitting, Emergency Room and medical staff and offers workable solutions.* Oversees the secondary review process; actively appeals denied cases when necessary and assists physicians with appeals. Maintains minimal denial rates by Medicare, MediCal, private and contracted payers through appropriate direction of utilization practices; assists physicians and hospital personnel in understanding care management issues* Provides in house educational programs as needed for both staff and physicians* Develops and provides statistical UM information and reports to appropriate committees and in conjunction with the Director of Care Management identifies utilization issues affecting the quality of patient care* In conjunction with VP and Director, coordinates, develops, and implements action plans to respond to areas felt to be in need of improvement related to patient flow and care coordination across the continuum* Prepares cost analysis reports and other data needed for the preparation of the departmental budget* Responsible to purchase, educate, and record education to new equipment and/or techniques* Conducts and records periodic staff meetings, to inform staff of changes in policies and procedures* Supervises technical procedures and performs procedures as needed* Perform all other duties as assignedMINIMUM QUALIFICATIONS:Preferred Education: Master's in Nursing or Master's in Social Work or Social WelfareRequired Experience: Five years of clinical nursing or social work experience in a directly related setting (e.g., acute care, skilled nursing, etc.); three years of case management experience; two years of experience in a supervisory or lead role.Required Licenses/Certifications: Active licensure as a Registered Nurse in the State of California or licensed in Clinical Social Work in California, Active BLS - Basic Life Support Certification issued by the American Heart Association. Other advanced life support certifications may be required per unit/department specialty according to patient care policies. CPI -Crisis Prevention Intervention TrainingPreferred Licenses/Certifications: Certification in Case Management, CCMC or ACM* San Leandro, CA * San Leandro Hospital * SLH Social Services * Full Time - Day * Management * Req #: 28158-18819 * FTE: 1 * Posted: December 9, 2020

Keywords: Alameda Health System, San Leandro , SLH Manager, Care Management, Executive , San Leandro, California

Click here to apply!

Didn't find what you're looking for? Search again!

I'm looking for
in category
within


Other Executive Jobs


Brand Manager
Description: What We Need 2K is looking for a creative and passionate Brand Manager to assist in the development and management of the global strategy for our Gearbox projects. Under direction of the Director, Global (more...)
Company: 2K
Location: Novato
Posted on: 01/19/2021

Project Issues Management & Analytics Specialist, Vice President
Description: Job Description - Project Issues Management Analytics Specialist, Vice President 10038534-WD Job Description Project Issues Management Analytics Specialist, Vice President-10038534-WD Description (more...)
Company: Union Bank of California
Location: Walnut Creek
Posted on: 01/19/2021

Strategic Client Director - High Tech Account
Description: Job Description - Strategic Client Director - High Tech Account 21000201 Job Description All over the world, people's lives are better because of Oracle. Want to make a difference Join our company of (more...)
Company: Oracle Corporation
Location: Pleasanton
Posted on: 01/19/2021


Financial Planning and Analysis Manager
Description: AI Sales Startup provides an automated sales assistant powered by artificial intelligence software. The assistant works just like a human sales assistant, reaching out to every single one of your leads (more...)
Company: Stealth Startup
Location: Palo Alto
Posted on: 01/19/2021

Director Of Engineering
Description: At 10x Genomics, accelerating our understanding of biology is more than a mission for us. It---s a commitment. This is the century of biology, and the breakthroughs we make now have the potential to change (more...)
Company: 10x Genomics
Location: Pleasanton
Posted on: 01/19/2021

Director of Biostatistics
Description: Why Join Us Be a hero for our rare disease patientsUltragenyx is a commercial-stage biopharmaceutical company committed to developing novel therapies for the treatment of rare and ultra-rare genetic diseases. (more...)
Company: Ultragenyx Pharmaceuticals
Location: Novato
Posted on: 01/19/2021

Senior Program Manager
Description: Senior Program ManagerLocation: Newark, CAQualifications: BS in Mechanical Engineering or similar engineering field Experience in Semiconductor equipment or capital equipment manufacturing industry (more...)
Company: SoloPoint Solutions
Location: Newark
Posted on: 01/19/2021

Growth Programs Marketing Manager
Description: About Bill.comBill.com is a leading provider of cloud-based software that simplifies, digitizes, and automates complex, back-office financial operations for small and midsize businesses. Customers use (more...)
Company: Bill.Com
Location: Palo Alto
Posted on: 01/19/2021

Manager, SA Proposal
Description: JOB REQUISITIONManager, SA ProposalLOCATIONSAN RAMONJOB DESCRIPTIONRobert Half is seeking a SA Proposal Manager to be part of team who supports and strategizes with the Strategic Accounts VP sales team (more...)
Company: Robert Half
Location: San Ramon
Posted on: 01/19/2021

Senior Product Manager
Description: It's fun to work in a company where people truly believe in what they're doing At Blackline, we're committed to bringing passion and customer focus to the business of enterprise applications.Since being (more...)
Company: BlackLine
Location: Pleasanton
Posted on: 01/19/2021

Log In or Create An Account

Get the latest California jobs by following @recnetCA on Twitter!

San Leandro RSS job feeds