Jobs
>
Oakland

    Manager, Care Management - Oakland, United States - Alameda Health System

    Alameda Health System
    Alameda Health System Oakland, United States

    1 day ago

    Default job background
    Description

    Summary



    Alameda Health System offers outstanding benefits that include:

    • 100% employer health plan for employees and their eligible dependents
    • Unique benefit offerings that are partially or 100% employer paid
    • Rich and varied retirement plans and the ability to participate in multiple plans.
    • Generous paid time off plans

    Role Overview:

    Alameda Health System is hiring The Manager of Care Management is responsible for the day-to-day operations of facility wide utilization, discharge planning and care coordination.

    DUTIES & ESSENTIAL JOB FUNCTIONS: The following are the duties performed by employees in this classification. However, employees may perform other related duties at an equivalent level. Not all duties listed are necessarily performed by everyone in the classification.

    -Assists Director in Establishing, implementing, and ensuring that care management policies, practices and procedures are in accordance with the Joint Commission, Title 22 and other regulatory agencies and overall hospital policies.

    -Conducts and records periodic staff meetings, to inform staff of changes in policies and procedures.

    -Conducts interdepartmental team conferences for identifying aberrant utilization; establishes a method of tracking variances based on critical timelines.

    -Develops and provides statistical UM information and reports to appropriate committees and in conjunction with the Director of Care Management identifies utilization issues affecting the quality of patient care.

    -Direct and coordinate data gathering and record keeping legally required by Federal and State agencies, the Joint Commission, and hospital policies; participates in the risk mitigation, process of implementing new or revised processes, and projects.

    -In conjunction with VP and Director, coordinates, develops, and implements action plans to respond to areas felt to need improvement related to patient flow and care coordination across the continuum.

    -Manages and assumes responsibility for day-to-day operations of utilization management, care coordination and discharge planning activities.

    -Manages process of pre-admission review of questionable admissions as referred by Admitting, Emergency Room and medical staff and offers workable solutions.

    -Oversees submission of any audits, including but not limited to MediCal, Medicare and internal compliance studies.

    -Oversees the secondary review process; actively appeals denied cases when necessary and assists physicians with appeals. Maintains minimal denial rates by Medicare, MediCal, private and contracted payors through appropriate direction of utilization practices; assists physicians and hospital personnel in understanding care management issues.

    -Perform all other duties as assigned.

    -Performs daily clinical rounds and monthly audit of charts on care management activities (utilization review, discharge planning and Interrater Reliability).

    -Prepares cost analysis reports and other data needed for the preparation of the departmental budget.

    -Provides in house educational programs as needed for both staff and physicians.

    -Responsible for the recruitment, orientation, evaluation, counseling and disciplinary action of care management clinical and administrative staff.

    -Responsible to purchase, educate, and record education to new equipment and/or techniques.

    -Reviews cases regularly with staff; acts as clinical consultant regarding care management issues; guides clinical staff with review of assessments and care plans, evaluates utilization reviews or documentation.

    -Serves as a content expert to staff and internal departments and external partners; networks with other hospitals, nursing organizations, and professional organizations to keep abreast of changes within the profession.

    -Supervises technical procedures and performs procedures as needed.

    MINIMUM QUALIFICATIONS:

    Preferred Licenses/Certifications: Certification in Case Management, CCMC or ACM.

    Preferred Education: Master's in Nursing or Masters in Social Work or related field.

    Required Experience: Five years of clinical nursing or social work experience in a directly related setting (e.g., acute care, skilled nursing, etc.); three years of case management experience; two years of experience in a supervisory or lead role.

    Required Licenses/Certifications: Active licensure as a Registered Nurse in the State of California or licensed in Clinical Social Work in California, Active BLS - Basic Life Support Certification issued by the American Heart Association. Other advanced life support certifications may be required per unit/department specialty according to patient care policies. CPI -Crisis Prevention Intervention Training (required for all positions at John George Psychiatric Pavilion; and certain positions in the Emergency Department



    Highland General Hospital
    HGH Care Coordination
    Full Time
    Day
    Management
    FTE: 1
  • Alameda Health System

    Care Management Specialist

    2 days ago

    Alameda Health System Oakland, United States

    **Summary** · **SUMMARY**:Assists in Care Management Team of social workers and nurses with functions such as but not limited to provide census reconciliation, administrative support for care coordination and discharge planning activities, working with the payors, accurate and cr ...

  • Altais Health Solutions

    Manager, Care Mgmt

    3 days ago

    Altais Health Solutions Oakland, United States

    **About Our Company** · At Altais, we're looking for bold and curious innovators who share our passion for enabling better health care experiences and revolutionizing the healthcare system for physicians, patients, and the clinical community. At Altais, we're building breakthroug ...

  • Altais Health Solutions

    Care Manager, Lvn

    3 days ago

    Altais Health Solutions Oakland, United States

    **About Our Company** · At Altais, we're looking for bold and curious innovators who share our passion for enabling better health care experiences and revolutionizing the healthcare system for physicians, patients, and the clinical community. Doctors today are faced with the real ...

  • Alameda Health System

    Care Management Community Health Worker

    3 days ago

    Alameda Health System Oakland, United States

    **Summary** · **SUMMARY**:Provides care coordination and advocacy to patients, including outreach and engagement, development of the care plan, linkage of the patient with resources (food, housing, transport, financial, community based services) as well as linking the patient wit ...

  • Institute on Aging

    Care Manager Iii

    3 days ago

    Institute on Aging San Francisco, United States

    IOA is on the forefront of revolutionary healthcare models, reshaping the way people can age in place. Our innovative models transform lives, enhance communities, and save healthcare systems millions of dollars. Rather than focusing on archaic outdated design, we strive to consis ...

  • Providence

    Care Manager Rn

    5 days ago

    Providence San Pedro, United States

    **Description** · Care Manager RN at Providence Little Co of Mary Medical Ctr-San Pedro in San Pedro, CA offers a Full-Time (Day shift) that will work 8-hour daily. The case manager performs the primary functions of assessment, planning, facilitation and advocacy, which are achie ...

  • Providence

    Care Manager Lcsw

    5 days ago

    Providence San Pedro, United States

    **Description** · Provides clinical social work services on the Crisis Stabilization Unit (CSU) in a manner consistent with the philosophy and objectives of LCM-SPH and the NASW. The Social Worker is responsible for psychosocial assessments. Participates in treatment team plannin ...

  • Altais

    Care Manager

    1 day ago

    Altais Oakland, United States

    Job Description · Job DescriptionAbout Our Company · At Altais, we're looking for bold and curious innovators who share our passion for enabling better health care experiences and revolutionizing the healthcare system for physicians, patients, and the clinical community. At Altai ...

  • Alameda Health System

    Manager, Care Management

    1 day ago

    Alameda Health System Oakland, United States

    Summary · Alameda Health System offers great benefits to our employees · 100% employer health plan for employees and their eligible dependents · Unique benefit offerings that are partially or 100% employer paid · Rich and varied retirement plans and the ability to participate i ...

  • Alameda Health System

    Manager, Care Management

    3 days ago

    Alameda Health System Oakland, United States

    Summary · Alameda Health System offers outstanding benefits that include: · 100% employer health plan for employees and their eligible dependents · Unique benefit offerings that are partially or 100% employer paid · Rich and varied retirement plans and the ability to participate ...

  • Alameda Health System

    Manager, Care Management

    3 days ago

    Alameda Health System Oakland, United States

    Summary · Alameda Health System offers great benefits to our employees · 100% employer health plan for employees and their eligible dependents · Unique benefit offerings that are partially or 100% employer paid · Rich and varied retirement plans and the ability to participate i ...

  • Glide Community Housing, Inc.

    Continuum of Care Case Manager

    2 days ago

    Glide Community Housing, Inc. San Francisco, United States

    ABOUT GLIDE COMMUNITY HOUSING, INC./SUPPORT SERVICES: · The Continuum of Care Case Manager will manage 22 CoC units in a subsidized · housing complex next to the Glide Methodist Church. The Continuum of Care (CoC) · Program (24 CFR part 578) is designed to promote a community-wid ...

  • Altais

    Manager, Care Management

    3 days ago

    Altais Oakland, United States

    Job Description · Job DescriptionAbout Our Company · At Altais, we're looking for bold and curious clinicians and innovators who share our passion for enabling better health care experiences and revolutionizing the healthcare system for physicians, advanced care providers, patien ...

  • Alameda Health System

    Manager, Care Management

    5 days ago

    Alameda Health System Oakland, United States Full time - Day

    Summary · Alameda Health System offers outstanding benefits that include: · 100% employer health plan for employees and their eligible dependents · Unique benefit offerings that are partially or 100% employer paid · Rich and varied retirement plans and the ability to participat ...

  • Aegis Living

    Medication Care Manager

    1 day ago

    Aegis Living Fremont, United States

    Overview: · Are you a licensed Certified Nursing Assistant (CNA) or Home Care Aide (HCA) with Nursing Delegation looking to grow your career? · Join Aegis Living as a Medication Care Manager where you will be valued and appreciated. You will receive respect from your superiors, c ...

  • Institute on Aging

    Care Manager I

    3 days ago

    Institute on Aging San Mateo, United States

    IOA is on the forefront of revolutionary healthcare models, reshaping the way people can age in place. Our innovative models transform lives, enhance communities, and save healthcare systems millions of dollars. Rather than focusing on archaic outdated design, we strive to consis ...

  • Alameda Health System

    Manager, Spiritual Care

    1 day ago

    Alameda Health System Oakland, United States

    Summary · SUMMARY: The Manager, Spiritual Care Department, plans, administers, manages, supports, advocates for, and evaluates the activities and staff of the Spiritual Care Department at Alameda, San Leandro, Fairmont, and Wilma Chan Highland Hospitals. The incumbent is respons ...

  • Alameda Health System

    Care Management Specialist

    1 week ago

    Alameda Health System Oakland, United States

    Summary · SUMMARY: Assists in Care Management Team of social workers and nurses with functions such as but not limited to provide census reconciliation, administrative support for care coordination and discharge planning activities, working with the payors, accurate and critical ...

  • Alameda Health System

    Manager, Spiritual Care

    3 days ago

    Alameda Health System Oakland, United States

    Summary · SUMMARY: The Manager, Spiritual Care Department, plans, administers, manages, supports, advocates for, and evaluates the activities and staff of the Spiritual Care Department at Alameda, San Leandro, Fairmont, and Wilma Chan Highland Hospitals. The incumbent is respons ...

  • Titanium Healthcare

    Lead Care Manager

    4 days ago

    Titanium Healthcare Oakland, United States

    Job Description · Job DescriptionSalary: $23 - $28 per hour DOE · Lead Care Manager Job Summary: The Lead Care Manager (LCM) is responsible for case management of members and their families in obtaining and understanding services and programs available through the Enhanced Care M ...