JOB DESCRIPTION
Primary Duties And Responsibilities
The Manager of Care Management is responsible for the daily oversight and management of inpatient and care management staff. This position must support, concurrent, retrospective inpatient review, discharge planning, transitional care and care management programs for Hoag MG and IPA assigned membership. They are responsible for helping to develop and implement any necessary P&P’s and workflow to ensure consistency, effectiveness and efficiency in the use of all resources required to accomplish all department goals and objectives. They will identify any opportunities for and implement any changes necessary to improve upon workflows and department performance that will ensure a high level of satisfaction with our customers and compliance with all Federal, State and Health Plan requirements. They will monitor the department performance against these requirements. They will be a resource to staff for addressing difficult issues that arise within the department. Interface with Medical Directors, hospitalists, physicians, other department leaders and vendors as needed.
JOB QUALIFICATIONS
Education and Experience
- Current RN license in the State of California
- BSN or Bachelor Degree in Health Care related field
- Minimum of 2 years of supervisory experience required in medical group or health plan setting
- Experience of at least two years with Inpatient Case Management and/or Outpatient Care Management
- Have an understanding of nationally recognized criteria Milliman Care Guidelines/Interqual/CMS, etc.
- Fulfills mandatory stroke education requirements per certification agency
License Required
Active unrestricted RN license in the State of California
