Providence Health & Services Director, Care Management - Utilization Care Management in Torrance, California

Description:

Providence is calling a Full Time, Day shift Director, Care Management - Utilization Care Management to Providence Little Company of Mary in Torrance, CA

In this position you will:

  • Provide departmental direction for the functions of Care Management, Utilization Management, Discharge Planning, Social Services, Clinical Documentation Specialists, Bed Board and Denial Management.

  • Responsibilities include all aspects and activities responsible for monitoring the delivery of care to patients, the development of strategies to reduce costs and ensure the appropriate utilization of facilities and services and to provide appropriate discharge planning for every patient to return to their optimum level of function.

  • The director oversees the collection, analysis, and reporting of financial and quality data related to utilization management, quality improvement, and performance improvement.

  • Plans, organizes, analyzes, develops and implements Departmental programs, services and strategies to ensure favorable Hospital operating results.

  • Adhere to all budgetary and productivity goals/standards.

  • Ensures the attainment of Department and Hospital goals, policies and procedures.

  • The director promotes interdisciplinary collaboration, fosters teamwork, and champions service excellence. Supervises FTEs in Care Management, Social Services, Bed Board, and Clinical Documentation Specialists.

Qualifications:

Required qualifications for this position include:

  • Bachelor’s in Nursing required

  • Experience in utilization management, case management, discharge planning, disease management and other cost/quality management programs.

  • Ten years multidisciplinary clinical experience including 7 years case management experience and two years management level supervisory experience

  • Requires California State Registered Nurse License

  • Green belt certification or willingness to attain within 18 month of hire.

  • Must have good oral and written communication skills.

  • Excellent customer services skills.

  • Basic computer skills, Word, Excel, Access and PowerPoint.

  • Knowledge regarding State andFederal regulations, HMO, PPO and Utilization processes

  • Knowledge of Discharge planning and Case Management

  • Knowledge of principles and practices of Utilization and Quality Management

  • Knowledge of CPT ICD-9 and ICD-10Coding

Preferred qualifications for this position include:

  • Masters in health care related field preferred

  • Certified Case Manager preferred

About the Region you will serve.

For nearly 70 years, Providence Health & Services, Southern California, has provided quality and compassionate health care, building on a tradition of excellence, innovation, teamwork and outreach to those most in need.

Anchored by five award-winning comprehensive medical centers, Providence provides a full spectrum of care that includes a range of specialties, signature services, outpatient and home care and the well-regarded Providence Medical Institute, a group of physicians and primary and urgent care clinics throughout the greater San Fernando Valley and South Bay. Providence is focused on providing the communities it serves with preventive care, education and leading-edge diagnostics and treatment. The organization includes numerous outreach programs. hospice and home care and even our own Providence High School, a Blue Ribbon college-preparatory campus.

We offer a full comprehensive range of benefits - see our website for details

http://www.providenceiscalling.jobs/rewards-benefits/

Our Mission

As expressions of God’s healing love, witnessed through the ministry of Jesus, we are steadfast in serving all, especially those who are poor and vulnerable.

About Us

Providence Health & Services is a not-for-profit Catholic network of hospitals, care centers, health plans, physicians, clinics, home health care and services guided by a Mission of caring the Sisters of Providence began over 160 years ago. Providence is proud to be an Equal Opportunity Employer. Providence does not discriminate on the basis of race, color, gender, disability, veteran, military status, religion, age, creed, national origin, sexual identity or expression, sexual orientation, marital status, genetic information, or any other basis prohibited by local, state, or federal law.

Schedule: Full-time

Shift: Day

Job Category: Director / Executive

Location: California-Torrance

Req ID: 203100