Organization:SMCS-Valley Administration
Position Overview:Supervises the overall operations of the department for Sutter Health entities in accordance with current Federal and State regulations and guidelines. Has frequent contact with Nurse Managers/ Directors, Risk and Ethics staff, Ancillary Services, Patient Access staff, Medical Staff leaders, physicians, Health Plans and contracted providers, community resources and post-acute agencies as well as patients and their families.
Job Description:
EDUCATION:- Master's: Nursing, Case Management, or Social Work
CERTIFICATION & LICENSURE:- LCSW-Licensed Clinical Social Worker Upon Hire
TYPICAL EXPERIENCE:- 5 years of recent relevant experience.
SKILLS AND KNOWLEDGE:- Strong critical-thinking, problem resolution and time management abilities and customer relation skills.
- 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, CDPH and TJC.
- Verbal and written communication skills.
- Demonstrated ability to develop and manage complex projects.
- Working knowledge of InterQual criteria.
- Working knowledge of MIDAS and experience with an E.H.R.
- 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 preferred.
- PC skills, word processing, spreadsheets and managed care software programs.
- Adheres to Sutter Health policies and procedures and supports Sutter Health philosophies and initiatives. Participates as a member of the utilization Management Committee (UMC).
Job Shift:Days
Schedule:Full Time
Days of the Week:Monday - Friday
Weekend Requirements:As Needed
Benefits:Yes
Unions:No
Position Status:Exempt
Weekly Hours:40
Employee Status:Regular
Pay Range is $138,881.60 to $208,332.80 / annual salary
The compensation range may vary based on the geographic location where the position is filled. Total compensation considers multiple factors, including, but not limited to a candidate's experience, education, skills, licensure, certifications, departmental equity, training, and organizational needs. Base pay is only one component of Sutter Health's comprehensive total rewards program. Eligible positions also include a comprehensive benefits package.
