Job: Director of Care Management - Outpatient Care Mgmt/Coordination

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Job Description

Community Health Innovations

Outpatient Care Mgmt/Coordination

Full Time (Exempt)

Day shift

Monday - Friday, days

80

CHI1709

Community Health Innovations (CHI) is an integrated Population Health Management Organization providing services to Monterey County. The organization provides a range of medical and behavioral health population and care management programs through innovative partnerships with community-based providers and affiliates.

CHI is looking for a Director of Care Management to be responsible for oversight of the design, development and operations associated with the care management programs and teams. These programs include: case management and care coordination, population health, and disease management. The programs also support effective delivery of medical home models within the healthcare system. The Director provides the leadership to ensure the company's care management performance objectives are met, programs and resources are used effectively and execution of both short term and long term care management company goals.

Responsibilities:

  1. Overseeing care management program operations and systems in close coordination and collaboration with partners.
  2. Promoting efficient and effective use of resources while supporting programs that result in improved cost effectiveness and quality outcomes across all levels of care.
  3. Participating in the design of new programs and strategies that meet the needs of the population.
  4. Supporting team development, effectiveness and performance improvement.
  5. Working collaboratively with physicians, health plans, hospitals, ancillary providers, the leadership team and other partners and stakeholders to promote interdisciplinary teamwork that fosters goal achievement.
  6. Being instrumental in the organization's growth and development, and continuously working to evaluate program effectiveness and develop opportunities for enhancement.
  7. Overseeing, educating and training the care management staff that deliver care management services in the acute and ambulatory settings, and differentiated services in various health plan programs.
  8. Other duties as assigned.

Qualifications:

  1. A minimum of five years' experience as a registered nurse and two years in care/case management leadership role.
  2. Current CA RN license
  3. Bachelors of Science degree in Nursing, Public Health, or related field or equivalent combination of experience and education
  4. Ability to analyze and integrate information and make sound decisions based upon established guidelines.
  5. Experience analyzing healthcare data in order to assess population needs and target interventions effectively.
  6. Thorough understanding of health plan and regulatory rules, managed care, care management, disease management and referral processes.
  7. Highly self-motivated, organized and detailed oriented with an attitude for continuous improvement.
  8. Proven success in teambuilding and training / coaching staff to meet operational requirements and goals.
  9. Must be able to prioritize, plan, and handle multiple tasks/demands simultaneously.
  10. Highly professional with excellent written and verbal communication skills
  11. Proficient with computer software programs, including Microsoft Word, Excel, Visio, and Electronic Health Records.

Preferences:

  1. Master's degree in Nursing, Public Health, or related field preferred
  2. Supervisory experience
  3. Experience in care management programs in payer or accountable care organizations

Equal Opportunity Employer

 

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