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Dir, Care Management and Transitions of Care

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Company: Heritage Healthcare

Location: Fullerton, CA

Date Posted: July 7, 2014

Source: Heritage Healthcare

Dir, Care Management and Transitions of Care-Fullerton - (14003941)

St. Joseph Heritage Healthcare (SJHH) is one of California's most respected medical groups. With over 2,000 employees and 25 locations throughout California, including, Northern California, Orange County, High Desert and Los Angeles County, SJHH has been continually recognized as a leader in quality, customer service and information technology. This kind of success is the result of team work, a commitment to excellence and a strong adherence to the organization's mission, vision and values.

The Director is responsible for the strategic planning, development, administration and operations of Care Management and Social Services for the hospital along with the Transitions of Care for patients. The Director has oversight for all aspects of daily operations to enable long-term and short-term goals to be achieved in a manner that is consistent with the mission values and strategic goals of the local ministries as ...

Dir, Care Management and Transitions of Care-Fullerton - (14003941)

St. Joseph Heritage Healthcare (SJHH) is one of California's most respected medical groups. With over 2,000 employees and 25 locations throughout California, including, Northern California, Orange County, High Desert and Los Angeles County, SJHH has been continually recognized as a leader in quality, customer service and information technology. This kind of success is the result of team work, a commitment to excellence and a strong adherence to the organization's mission, vision and values.

The Director is responsible for the strategic planning, development, administration and operations of Care Management and Social Services for the hospital along with the Transitions of Care for patients. The Director has oversight for all aspects of daily operations to enable long-term and short-term goals to be achieved in a manner that is consistent with the mission values and strategic goals of the local ministries as well as across the region for St. Joseph Heritage Healthcare. This position is responsible for maintaining integration between the departments within the hospital as well as across the continuum. The Director is accountable for achieving established performance targets through actively engaging multiple disciplines and professional staff with both internal and external stakeholders. The Director reports directly to the Vice President of Care Integration of St. Joseph Heritage Healthcare with a matrix reporting structure to the local Ministry and Network.

Essential Functions:
Directs all care management/social service functions within the hospital and the transition of care. Responsible for establishing and maintaining systems and processes that optimally provide for effective and efficient delivery of patient care. Works closely with leadership in establishing and maintaining systems that optimize outcomes for all entities involved. This includes prospective, concurrent and retrospective utilization management, discharge planning, and social work functions. Assures inter-rater consistency and staff competencies.
Integrates and coordinates all related services of Care Management within the hospital with the associated Physician Networks. Develops integrated plans that effectively transition patients throughout the continuum
Directs the processes necessary for data collection and the management of pertinent integrated information. Participates in the review, interpretation and decision-making regarding resource management. Monitors and tracks variant/avoidable bed days/visits and other utilization trends. Reports data as required to appropriate entities. Implements corrective actions as deemed appropriate.
Creates a collaborative team both within the ministry as well as across the continuum with all departments which impact care management, social services and utilization management outcomes. This includes coordination and communication with Medical Staff, Nursing, Quality, Revenue Cycle Services, Health Information Management, Contracting, the ambulatory setting and other functional areas that impact the flow of patient care and the utilization of resources.
Develops and manages operational and capital budgets, including ensuring staffing schedules are consistent with targeted productivity.
Maintains comprehensive knowledge of payor and Regulatory requirements assuring that all functions meet internal, Health Plan, and regulatory body requirements.

Additional Responsibilities: Performs all other duties as assigned.

Minimum Position Qualifications:
Education: Requires a Bachelor’s degree in Nursing.

Experience:
Requires three (3) years’ experience in Care Management/Utilization Management.
Three (3) years management in acute care setting required.
Requires five (5) years’ clinical and administrative experience.

License / Certification:
Current RN License State of California
Active CPR Certificate

Computer Skills: Basic computer skills in a Windows environment required.

Other: Valid California driver’s license and automobile insurance for employee-owned vehicles.

Knowledge / Skills / Abilities:
Must be a dynamic leader, able to navigate a complex environment, with excellent verbal and written communication skills, as well as strong project management and operations experience.
Ability to effectively interact and establish immediate credibility with all levels of management, physicians, staff, patients, and community leaders.
Effective influencing, negotiation, relationship-building and communication skills are essential.
Ability to work effectively under pressure, due to change priorities.
Ability to work with Information Service department to maintain performance of computer hardware and software within the department.
Effective employee management skills.
Ability to lead through influence and persuasion.
Ability to facilitate the integration of the finance, operations, and strategic functions of the organization.
Possess strong leadership, critical-thinking and motivational skills/abilities.
Knowledge of ambulatory healthcare delivery and management.
Ability to build consensus across organizational lines.
Ability to adapt quickly to changing conditions while managing multiple priorities.
Ability to work independently, self-direct activities.
Excellent organizational skills.
Ability to work effectively and establish and promote positive relationships.
Ability to travel between St. Joseph Health locations.

Preferred Position Qualifications:
Education: Master’s degree in Nursing or related field highly desirable.

Experience: Five (5) years in Management of Inpatient Care.

License/Certification: Certified Case Manager (CCM) or Accredited Case Manager (ACM) highly desirable.

Computer Skills: Proficient in all MS Office applications.

Other: Bilingual English/Spanish communication skills

Organization
: SJHH Administration

Work Locations
:
2151 E. Valencia Mesa Dr.

2151 E. Valencia Mesa Dr.

FULLERTON 92835

Employee Status
: Regular

Schedule
: Full-time

Work Schedule: 8 Hour

Shift
: Day

Variable Shift: Yes

Travel
: Yes, 25 % of the Time

Job
: Management

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