(RN) Manager, Care Management - 116964
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#116964 (RN) Manager, Care ManagementInitial Review Date: Mon 6/27/2022
For the safety and well-being of the entire university community, the University of California requires, with few exceptions, that all students, faculty and staff be vaccinated against the COVID-19 virus and influenza before they will be allowed on campus or in a facility or office. For more information visit: Flu Vaccine Mandate / COVID Vaccine Policy
Special Selection Applicants: Apply by 06/27/2022. Eligible Special Selection clients should contact their Disability Counselor for assistance.
UC San Diego Health is a Magnet designated organization, which is a prestigious recognition that applies to only 10% of all U.S. hospitals. Magnet is the "gold standard" for nursing excellence and is based on strengths in five key areas, which include transformational leadership, structural empowerment, exemplary professional practice, new knowledge, innovation and improvements and empirical outcomes. UC San Diego Health has held its Magnet status since 2011.
With a growing patient population and market share, the UC San Diego Health Care Management team is growing! The department is seeking an experienced Case Management Manager to join their leadership team.
The Manager of Care Management is responsible and accountable for providing administrative and clinical leadership for the Care Management Department. Develops standard workflows of care management that demonstrates success in: promoting high quality, cost effective delivery of care; ensuring effective utilization of resources across the continuum; excellent customer service; and compliance with regulatory and internal UCSD requirements. Spearheads innovative projects and approaches involving multi-disciplinary factions for systems improvement that affects patient outcomes and length of stay across the organization. Plans, schedules and organizes work for department ensuring proper distribution of assignments and efficient utilization of personnel, space and facilities.
The Manager of Care Management supervises staff, screens candidates, interviews and hires new employees. Ensures staff competence, compliance with staff licensure/certification requirements and maintenance of related documentation. Conducts performance appraisals, counsels staff, and takes disciplinary action as required in consultation with Human Resources/Labor Relations. Ensures compliance with discipline-related action plans.
- Manages the staff responsible for case management to include all or most of the following: utilization management, discharge planning, social work services, denial management, and patient throughput.
- Implements operational processes that contribute to effective and efficient workflow coordination among physicians, clinicians, and other patient care and support staff, from across the medical center.
- Works with Information Technology managers to promote and support care coordination and case management review interests in organization-wide IT initiatives, including electronic medical records, revenue management, patient finance, and business intelligence.
- Evaluates effectiveness of case management interventions based on analysis of Line of Duty (LOD) care, readmissions, staff and patient satisfaction, and financial indicators.
- Works with members of the interdisciplinary team to support the continuous improvement of expedited patient care delivery, throughput processes and transitions across the continuum. Recommends quality improvement measures and plans.
- Participates on organization wide committees to facilitate integration of the case management into patient care delivery models.
- Works with colleagues across the medical center to ensure compliance with accreditation and licensure requirements within the clinical services environment, including JCAHO, CMS, and State of California.
- Responsible for employee recruitment, performance evaluation and management, and staff development and training.
- Develops a strong culture of teamwork to ensure the quality of daily operations, effective interdepartmental collaborations, and the timely achievement of objectives.
- Keeps abreast of best practice research to identify and propose opportunities to improve both patient quality of care and the financial outcomes for the medical center.
- Other duties as assigned.
While not required, a cover letter is highly recommended when applying to this position.
Bachelor's degree in nursing and seven (7+) or more years of relevant experience in clinical case management; or equivalent combination of experience, education and training.
Minimum two (2) years of Case Management leadership experience in a tertiary or quaternary healthcare environment.
Experience and proven success in hospital management skills, with progressive expertise in case management, utilization review, discharge planning, home care and/or managed care.
- Master's degree in nursing.
- Working knowledge of Milliman Care Guidelines or InterQual.
- Must be able to work various hours and locations based on business needs.
- Employment is subject to a criminal background check and pre-employment physical.
UC San Diego Health was recently ranked third among the top academic medical centers in the U.S. for excellence in delivering high-quality care. The ranking is based on the Vizient Quality and Accountability dashboard which measures safety, mortality, clinical effectiveness, efficiency and patient centeredness.
Our employees enjoy competitive compensation packages in a diverse, stimulating workforce. These positions are eligible for full benefits first day of hire, including but not limited to:
* Health/Dental/Vision insurance
* 15 vacation days, 12 sick days, and 14 paid holidays per year
* Work life balance
* UC Retirement Plan
* Pet insurance
Job offer is contingent on successful engagement in the UC COVID-19 Vaccination program (fully vaccinated with documented proof or approved exception/deferral).
If applicable, life-support certifications (BLS, NRP, ACLS, etc.) must include hands-on practice and in-person skills assessment; online-only certification is not acceptable.
UC San Diego Health is the only academic health system in the San Diego region, providing leading-edge care in patient care, biomedical research, education, and community service. Our facilities include two university hospitals, a National Cancer Institute-designated Comprehensive Cancer Center, Shiley Eye Institute, Sulpizio Cardiovascular Center, the only Burn Center in the county, and and dozens of outpatient clinics. We invite you to join our team!
Applications/Resumes are accepted for current job openings only. For full consideration on any job, applications must be received prior to the initial closing date. If a job has an extended deadline, applications/resumes will be considered during the extension period; however, a job may be filled before the extended date is reached.
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UC San Diego Health is an Equal Opportunity/Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, age, protected veteran status, gender identity or sexual orientation. For the complete University of California nondiscrimination and affirmative action policy see: http://www-hr.ucsd.edu/saa/nondiscr.html
UC San Diego is a smoke and tobacco free environment. Please visit smokefree.ucsd.edu for more information.