Manager, Care Coordination
Employment Type: Full-Time
The Manager of Care Coordination (CC) directs the day to day operations for the CPMC Mission Bernal Care Coordination team.
The Manager of Care Coordination works closely with the interdisciplinary and Administrative Team to align Care Coordination operations with affiliate and Operating Unit goals and targets. The Manager of Care Coordination collaborates with the Utilization Management Physician Advisor and Medical Director. The Manager of Care Coordination reports to the Director for all CPMC campuses. Reporting to this position are RN Case Managers, Medical Social Workers, Administrative assistants, Case Management Assistants and other support staff for the department. The Manager of Care Coordination has frequent contact with Nursing Executives and Directors, Quality Directors, Ancillary Services Directors, Claims and Finance departments, Medical Directors, Medical Staff leaders, physicians, payers and review agencies, contracted providers and community resources as well as contact with patients/families.
* BS in in one of the following: Nursing or Health Administration is required
* MS in Nursing, Case Management, or related field desired
* CA RN current license required for RN candidates; LCSW for Social Worker candidates
* National Certification in Case Management (ACM, ANA RN-BC Case Management) within 18 months of hire
* Experience leading innovative case management programs.
* Strong problem resolution abilities and customer relation skills
* Experience planning, leading and organizing the resources of a team preferred.
* Experience in patient care or health education in variety of settings preferred.
* Experience in utilization management and discharge planning required.
* Leadership experience in acute case management required.
* Experience with clinical assessment for clients with complex medical, emotional and social needs.
* Experience in coordinating UM Committees/and or Clinical Review teams.
* Experience coaching, counseling and administering corrective action.
* 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, and TJC.
* Excellent verbal and written communication skills.
* Group presentation design and facilitation skills.
* Demonstrated ability to develop and manage complex projects.
* Working knowledge of Inter-Qual criteria.
* Working knowledge of MIDAS and experience with an E.H.R. (EPIC preferred)
* 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.
PC skills, word processing, spreadsheets and managed care software programs.