OaklandRecruiter Since 2001
the smart solution for Oakland jobs

Director, Inpatient System Care Management

Company: Alameda Health Sytem
Location: Oakland
Posted on: February 25, 2021

Job Description:

Director, Inpatient System Care Management SUMMARY: Alameda Health System is seeking an experienced Director of Inpatient System Care Management.--If you have a passion for supporting an underserved population this may be your next opportunity! This is a system wide positon and someone with knowledge within skilled nursing regulations would be a plus. We have a hard working team that is passionate about care management and the population they serve.-- Under the direction of the Vice President of Care Management, manages the day to day operations of the inpatient Care Management across all AHS facilities,--including post-acute care facility--for ensuring efficient patient flow, beginning when a patient is admitted to the facility and ending with a safe and clinically appropriate discharge . 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.

  • Accountable for Patient Care Coordination activities including system-wide Case Management, Care Coordination and Discharge Planning.--
  • Aligns Case Management with AHS strategic and operational objectives.
  • Optimizes efficient Care Management/care coordination roles and processes; initiates process improvements.
  • Develops, monitors and evaluates inpatient Care Management Metrics; manages the collection, analysis and presentation data relevant to the utilization of healthcare resources including but not limited to avoidable/variance days, readmissions, one-day stays, DRGs, LOS.
  • Develops, maintains and implements Case Management policies, practices and procedures in accordance with CMS, CA DCHS, the Joint Commission, Title 22 and other regulatory agencies and overall hospital policies; integrates managed care contract criteria into overall Case Management functions.
  • Works closely with the VP of Care Management and Physician Advisors on any audits and secondary reviews; may include but not limited to Direct and coordinate data gathering, chart audits and participants in internal and external meetings.
  • Oversees educational needs and plan for inpatient Care Management division.
  • Recruits, trains and coaches the management staff to assist them with performing optimally and provides appropriate discipline/structure; consults and assists Care Management managers with problem solving with staffing, personnel issues, budget issues and resource management; reviews and evaluates management staff performance, initiate personnel transactions and meet hospital standard for performance evaluations.
  • Supports the VP of CM with completion of financial analyses including cost of care to reimbursement, denials management, and non-reimbursed services, promoting effective resource utilization, clinical documentation/queries quality care and patient safety; oversees the Inpatient recovery process; works closely with Revenue Cycle and AHS Physician Advisors; regularly communicates with payors and/or their contracted vendors.
  • Responsible for the coordination and support of the AHS Utilization Review Committee.
  • Responsible of overseeing patient, physician and staff satisfaction based on quality outcomes and patient experience reporting; in conjunction with the Quality Leadership, identifies utilization issues affecting the quality of patient care.
  • Provides AHS physicians, nursing and staff education including InterQual-- criteria methodology, resource management, medical necessity guidelines payer sources, clinical outcome metrics, length of stay initiatives, readmission strategies, reimbursement rules and medical record documentation requirements.
  • Serves as Content Expert/Liaison to community agencies, AHS and Non AHS primary care provider network and all AHS stakeholders across all AHS facilities (i.e. Nursing and Hospital Administrators) for provision of care and services across the continuum of care.
  • In conjunction with department managers and/or supervisors, 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.
  • Assumes accountability for improving utilization metrics associated with department/unit and meeting organizational/departmental targets.
  • Evaluates, plans, and executes changes in department procedures, equipment and supplies.
  • Performs all other duties as assigned. MINIMUM QUALIFICATIONS:Required Education : Master's degree in Nursing or Master's degree in Social Work or related field. Required Experience: Seven to ten years of case management or quality experience in addition to progressive management experience in a large healthcare organization is required. Preferred Experience: N/A Required Licenses/Certifications: Active licensure as a Registered Nurse in the State of California or valid license as a Clinical Social Worker issued by the State of California Board of Behavior Science Examiners; active BLS - Basic Life Support Certification issued by the American Heart Association; CPI -Crisis Prevention Intervention Training; Other advanced life support certifications may be required per unit/department specialty according to patient care policies. Preferred Licenses/Certifications: Certification in Case Management, CCMC or ACM. Not the right fit?
    Join our Talent Network to opt-in to all our current and future opportunities!

Keywords: Alameda Health Sytem, Oakland , Director, Inpatient System Care Management, Executive , Oakland, California

Click here to apply!

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

I'm looking for
in category

Other Executive Jobs

Director of Development Operations and Direct Response
Description: Scion Executive Search has been retained to conduct the search for a Director of Development Operations Direct Response at Guide Dogs for the Blind GDB . This exciting position reports to Interim (more...)
Company: Scion Staffing
Location: San Rafael
Posted on: 03/2/2021

Director of Finance and Operations
Description: St. Vincent de Paul Society of Marin County is an independent, nonprofit organization with a goal to provide compassionate care and critical services to residents of Marin County who are struggling to (more...)
Company: San Rafael Chamber of Commerce.
Location: San Rafael
Posted on: 03/2/2021

Senior Manager I, Program Management, eComm, Marke...
Description: Position Summary...What
Company: walmart
Location: San Bruno
Posted on: 03/2/2021

Senior IVY Ecosystem Technical Alliance Manager
Description: Senior IVY Ecosystem Technical Alliance Manager San Ramon, California Worker Sub-Type:Regular --Job Description:-- Position Summary:The candidate will be responsible to onboard and support various ecosystem (more...)
Company: BlackBerry Inc.
Location: San Ramon
Posted on: 03/2/2021

Sr. Executive Assistant to President
Description: Senior Executive Assistant br The Senior Executive Assistant role ensures the effectiveness of the leadership team and provides executive assistance to the President. Responsibilities will include the (more...)
Company: A nationally recognized manufacturer
Location: Petaluma
Posted on: 03/2/2021

OEM Channel Sales Manager
Description: Worker Sub-Type:Regular --Job Description:-- Today, BlackBerry-- is a transformed company. We are no longer about the smartphone, what we once did for smartphones is what we're now doing for Enterprise (more...)
Company: BlackBerry Inc.
Location: San Ramon
Posted on: 03/2/2021

Editorial Director
Description: Worker Sub-Type:Regular --Job Description:-- BlackBerry-- - the iconic brand you know and trust - is now a market-leading cybersecurity software and services company.-- Today, BlackBerry already secures (more...)
Company: BlackBerry Inc.
Location: San Ramon
Posted on: 03/2/2021

Zone Manager
Description: The Zone Manager's primary job function is to be fully accountable for the success of an assigned group of districts and driving sales by directing all operational aspects of district and store operations. (more...)
Company: Spencer's
Location: Dublin
Posted on: 03/2/2021

Assistant Store Manager (32 hours/week)
Description: Job Description Are you an enthusiastic, creative, and ambitious self-starter Extra
Company: Extra Space Storage
Location: Rohnert Park
Posted on: 03/2/2021

Senior IVY Ecosystems Business Development Manager
Description: Workday is performing planned maintenance during the
Company: BlackBerry Inc.
Location: San Ramon
Posted on: 03/2/2021

Log In or Create An Account

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

Oakland RSS job feeds