Supervisor, Care Managment - Sutter Health
Vallejo, CA
About the Job
Organization:
SMCS-Valley Administration
Position Overview:
Supervises the overall operations of the Care Coordination 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:
+ Bachelor's: BS in Nursing or evidence of enrollment in BSN program with completion within 24 months or Master's: Master of Social Work for Social Work Candidates Only OR Master's: MS in Nursing, Case management OR Bachelor's in a related field.
CERTIFICATION & LICENSURE:
+ RN-Registered Nurse of California
TYPICAL EXPERIENCE:
+ 5 years of recent relevant experience.
SKILLS AND KNOWLEDGE:
+ 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
Shift Hours:
8
Days of the Week:
Monday - Friday
Weekend Requirements:
As Needed
Benefits:
Yes
Unions:
No
Position Status:
Exempt
Weekly Hours:
40
Employee Status:
Regular
Number of Openings:
1
This position may regularly work, store, prepare, receive, unpack, transport, dispose of, or administer drug(s) identified as hazardous, or potentially hazardous, by the National Institute for Occupational Safety and Health (NIOSH) for purposes of USP 800.
Sutter Health is an equal opportunity employer EOE/M/F/Disability/Veterans.
Pay Range is $87.68 to $109.59 / hour
_The salary range for this role may vary above or below the posted range as determined by location. This range has not been adjusted for any specific geographic differential applicable by area where the position may be filled. Compensation takes into account several factors including but not limited to a candidate’s experience, education, skills, licensure and certifications, department equity, training and organizational needs. Base pay is just one piece of the total rewards program offered by Sutter Health. Eligible roles also qualify for a comprehensive benefits package._
All qualified applicants will receive consideration for employment without regard to race, color, creed, religion, marital status, sexual orientation, registered domestic partner status, sex, gender, gender identity or expression, ancestry, national origin (including possession of a driver's license issued to individuals who did not present proof of authorized presence in the U.S.), age, medical condition, physical or mental disability, military or protected veteran status, political affiliation, pregnancy or perceived pregnancy, childbirth, breastfeeding or related medical condition, genetic information or any other characteristic made unlawful by local, state, or federal law, ordinance or regulation. External hires must pass a background check/drug screening. Qualified applicants with arrest and/or conviction records will be considered for employment in a manner consistent with Federal, state, and local laws, including but not limited to the San Francisco Fair Chance Ordinance.
SMCS-Valley Administration
Position Overview:
Supervises the overall operations of the Care Coordination 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:
+ Bachelor's: BS in Nursing or evidence of enrollment in BSN program with completion within 24 months or Master's: Master of Social Work for Social Work Candidates Only OR Master's: MS in Nursing, Case management OR Bachelor's in a related field.
CERTIFICATION & LICENSURE:
+ RN-Registered Nurse of California
TYPICAL EXPERIENCE:
+ 5 years of recent relevant experience.
SKILLS AND KNOWLEDGE:
+ 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
Shift Hours:
8
Days of the Week:
Monday - Friday
Weekend Requirements:
As Needed
Benefits:
Yes
Unions:
No
Position Status:
Exempt
Weekly Hours:
40
Employee Status:
Regular
Number of Openings:
1
This position may regularly work, store, prepare, receive, unpack, transport, dispose of, or administer drug(s) identified as hazardous, or potentially hazardous, by the National Institute for Occupational Safety and Health (NIOSH) for purposes of USP 800.
Sutter Health is an equal opportunity employer EOE/M/F/Disability/Veterans.
Pay Range is $87.68 to $109.59 / hour
_The salary range for this role may vary above or below the posted range as determined by location. This range has not been adjusted for any specific geographic differential applicable by area where the position may be filled. Compensation takes into account several factors including but not limited to a candidate’s experience, education, skills, licensure and certifications, department equity, training and organizational needs. Base pay is just one piece of the total rewards program offered by Sutter Health. Eligible roles also qualify for a comprehensive benefits package._
All qualified applicants will receive consideration for employment without regard to race, color, creed, religion, marital status, sexual orientation, registered domestic partner status, sex, gender, gender identity or expression, ancestry, national origin (including possession of a driver's license issued to individuals who did not present proof of authorized presence in the U.S.), age, medical condition, physical or mental disability, military or protected veteran status, political affiliation, pregnancy or perceived pregnancy, childbirth, breastfeeding or related medical condition, genetic information or any other characteristic made unlawful by local, state, or federal law, ordinance or regulation. External hires must pass a background check/drug screening. Qualified applicants with arrest and/or conviction records will be considered for employment in a manner consistent with Federal, state, and local laws, including but not limited to the San Francisco Fair Chance Ordinance.
Source : Sutter Health
