- Supervises staff in day-to-day functions, including training and developing the case management and care coordination staff to accomplish program goals and objectives.
- Assists in the development, maintenance, and implementation of metrics to appraise the productivity and quality of staff performance.
- Supervises the management and care coordination of identified high-risk members to reduce recurrent and unnecessary hospital admissions, readmissions, and emergency room visits.
- Works in close collaboration with Interdisciplinary Care Team and contracted physician groups who conduct assessments to establish members' care needs.
- Supervises the process to promote smooth transitions of care for targeted members.
- Coordinates individually needed interventions for select members based on CHG-established indicators.
- Guides case managers and care coordinators with difficult cases and situations; assumes responsibility for cases when risk management issues are identified.
- The Health Care Services management team works to develop, implement, and evaluate interventions designed to enhance member outcomes, and quality metrics, and increase customer satisfaction.
- Functions as a resource to internal and external customers.
- Graduate from an accredited school of nursing or other clinical-related field required
- A BA degree in a health-related field preferred
- Certification in case management is preferred.
- 2 years experience as a high-risk case manager and 1-year experience in a managed care environment, hospital discharge planning, or outpatient clinic is required.
- 1 year of supervisory experience preferred.
- Knowledge of population health, care/case management clinical operations, and management expertise relating to business planning, process improvement, budget administration, and personnel management.
- Working knowledge of Microsoft programs; proficiency with Word and Excel.
- Knowledge of managed care principles, CPT, ICD-10, HCPCS coding, and experience with inpatient and outpatient medical review guidelines (MCG).
- Familiar with Medi-Cal, and Medicare. Familiar with Web-based standard of care sites i.e. NIH, ACOG.
- Ability to communicate effectively verbally and in writing; exceptional telephone and customer service skills; ability to establish effective working relationships with physicians and medical professionals;
- May be required to conduct in-person visits and assessment of members.
- Prolonged periods of sitting at a desk; intermittent standing, walking, and bending.
- May be necessary to work and attend meetings outside of the facility or during normal business hours.
- Lifting 10 lb. or less.
- Driving within the County of San Diego
- California driver's license in good standing.
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Splicing Manager/supervisor
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Supervisor - Case Management II Supervisor
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Community Health Group Chula Vista, United StatesJob Details · Job Location · Corporate Headquarters - Chula Vista, CA · Salary Range · $102, $122,585.93 Salary/year · Description · POSITION SUMMARY · Provides supervision to the Clinical Case Managers in Community Health Group's (CHG's) High-Risk Case Management program, a ...
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Inclusion Technician
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CAPTEK Softgel International Vista, United StatesBecome part of a team that champions wellness worldwide. CAPTEK Softgel International is a global leader in the development and production of high-quality nutraceutical supplements. As a contract manufacturer organization (CMO), we collaborate with innovators from some of the wor ...
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Marine Group Boat Works LLC Chula Vista, United States: · The Project Managers are the primary interface with our Customers and are empowered and expected to deliver a world-class customer experience to all the vessel owners and owners representatives involved. Overall responsibility of managing a superyacht or commercial vessel ref ...
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Plumbing Technician
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RotoCo, Inc. dba Roto-Rooter Plumbing Vista, United StatesDo you enjoy being there to help people when they are in need? Do you take pride in solving critical technical issues when someone may feel panicked? Are you excited by structured career development opportunities in a uniquely large and rapidly growing company in the plumbing and ...
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Quality Assurance Manager
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Captek Softgel International, Inc. Vista, United States**Position Summary**: The Quality Assurance Manager is responsible for the whole oversight of the Quality Assurance, and floor quality at both manufacturing and packaging sites. They are to appropriate, delegate, and review Quality Assurance operations and related tasks to ensure ...
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Assistant Community Manager
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Greystar Real Estate Partners LLC Chula Vista, United StatesSupports and assists the Community Manager in overseeing and managing the financial and operational facets of the community by completing accounting and bookkeeping tasks, preparing monthly close-out and financial reports, processing invoices for payment, collecting rent, fees, a ...
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Office Manager
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Beacon Oral Specialists Chula Vista, United States**Job Title: Office Manager** · **Job Location: Chula Vista Oral & Maxillofacial Surgery, **Chula Vista, CA · **Job Type**:Fulltime · **Your new career awaits you...** · Are you looking for a company that you can call home and have opportunities to grow? The Office Manager will c ...
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Hotel Front Office Manager
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Motel 6 - Chula Vista Chula Vista, United StatesMotel 6 Chula Vista is currently seeking a dynamic and responsible individual to join our hotel team as a Front Office Manager (MOD). As the MOD, you will have the exciting opportunity to temporarily assume the role and responsibilities of the General Manager, ensuring the smooth ...
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Customer Service Coordinator
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Interior Logic Group Chula Vista, United StatesLooking to build your career and design your future? You have come to the right place. · Overview · The primary responsibility of the Customer Service Coordinator is to work with our customers (builders) and homeowners on concerns or issues that arise from prior ILG installations ...
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Clinical Supervisor
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Meruelo Group Vista, United StatesWe have an exciting opportunity for a Project Coordinator. · **ESSENTIAL DUTIES**: · - Create a PO/MOD tracking log · - Follow up on unsigned PO's, notify PM if there is an issue receiving returned PO's/MODs Timely (un-entered PO/MOD affect the PCA) · - Change Order Budgets entry ...
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Front Porch Chula Vista, United StatesFredericka Manor is Hiring · Maintenance I · Full-Time · Monday-Friday, 7:30am-4:00pm · Flexible on Weekends · $ per hour · **JOB SUMMARY** · Under the direction of the Manager of Building Services and/or Director of Maintenance, installs, maintains, paints, and performs basic ma ...
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Operations Supervisor
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Living Spaces Vista, United States Full timePosition Summary · The primary role of the Operations Supervisor is to oversee every aspect of Operations, through Standard Work and the Operations GEM Model. The Operations Supervisor will oversee a team of Operations Leads to achieve success in all customer interactions and tra ...
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Case Manager
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supervisor - case management ii supervisor - Chula Vista, CA , USA, United States - Community Health Group
Description
POSITION SUMMARY
Provides supervision to the Clinical Case Managers in Community Health Group's (CHG's) High-Risk Case Management program, and is responsible for the optimal and timely delivery of proactive and collaborative case management and care coordination activities.
COMPLIANCE WITH REGULATIONS
Works closely with all departments necessary to ensure that the processes, programs, and services are accomplished in a timely and efficient manner by CHG policies and procedures and in compliance with applicable state and federal regulations including CMS and/or Medicare Part D, DHCS, and DHMC.
RESPONSIBILITIES
EDUCATION
OTHER REQUIREMENTS
Community Health Group is an equal-opportunity employer that is committed to diversity and inclusion in the workplace. We prohibit discrimination and harassment based on any protected characteristic as outlined by federal, state, or local laws.
This policy applies to all employment practices within our organization, including hiring, recruiting, promotion, termination, layoff, recall, leave of absence, compensation, benefits, training, and apprenticeship.
Community Health Group makes hiring decisions based solely on qualifications, merit, and business needs at the time. For more information, see Personnel Policy 3101 Equal Employment Opportunity/Affirmative Action.
supervisor - case management ii supervisor professionals in Chula Vista
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J Manuel Madrigal
Industrial Engineer