Director, Care Management - RN

Location: California-Los Angeles - Apple Valley
Duration: Full Time
Job ID: 21600998
Company: ProEnlist
Contact: April Estes    Call: 7204392609
Job Posted: 04/28/21

Director, Care Management - RN - 21600998

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 Providence St. Joseph 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.

  • Directs all care management/social services 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. 
  • Directs the processes necessary for data collection and the management of pertinent integrated information. Participate in the review, interpretation and decision- making regarding resource management. Monitors and tracks variant/avoidable bed day/visits and other utilization trends. Reports data as required to appropriate entities. Implements corrective action 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.
  • Develops and manages operational and capital budgets, including ensuring staffing schedules are consistent with targeted productivity and the Collective Bargaining Agreement. 
  • Maintains comprehensive knowledge of payor and Regulatory requirements assuring that all functions meet internal, Health Plan and regulatory body requirements.

Education: Bachelor’s Degree required. 
  • 6 – 8 years of clinical operational leadership experience that provided the opportunity to manage a variety of patient care services in a complex healthcare environment.  
  • Five (5) or more years Director/Manager level experience in Case Management prefer experience in a variety of healthcare settings, from acute care inpatient facilities to Outpatient clinics. 
Training: Case Management, Clinical and Management required. CCM certification preferred. 
License / Certification: Current California RN License by evidence of Primary Source Verification

Knowledge & Skills:
  • Dynamic leader, able to navigate a complex environment, with excellent verbal and written communication skills as well as strong project management with operations experience. 
  • Ability to effectively interact and establish immediate credibility with all levels of management, physicians, caregivers, patients and community leaders. 
  • Effective influencing, negotiation, relationship building and communication skills are essential.
  • Ability to work effectively under pressure, due to change priorities. 
  • Effective caregiver management skills. 
  • Ability to lead through influence and persuasion. 
  • Possess strong leadership, critical thinking and motivational skills/abilities. 
  • Ability to build consensus across organizational lines. 
  • Ability to adapt quickly to changing conditions which managing multiple priorities. 
  • Ability to work independently, self-directed activities. 
  • Ability to work effectively and establish and promote positive relationships. 
  • Excellent oral and written communication skills.