Sutter Health Director of Care Coordination in Modesto, California

Description

Serving the greater Stanislaus County with 423 plus acute care beds, Memorial Medical Center provides a full continuum of care including 24-hour emergency care, inpatient and outpatient surgery, obstetrics, pediatrics, nuclear medicine, dialysis therapy, diagnostic imaging, intensive care, physical therapy, and home health. Specialized care includes Memorial Regional Cancer Center and Memorial Heart Institute.

The Care Coordination Director is responsible for Care Coordination operations for Sutter area Hospitals as assigned. The Director is accountable for all campuses as assigned. The Director works closely with the interdisciplinary, physician and administrative team to align Care Coordination activities and achieve desired goals and metrics. The Care Coordination Director reports to the Valley Area VP of Care Management or to the Executive Director of Care Coordination. Reporting to this position are the Care Coordination supervisors and managers at the assigned facilities. The Care Coordination Director has frequent contact with Administrators, Nursing Executives and Directors, Quality Directors, Ancillary Services Directors, Sutter Connect Provider Relations, Claims and Finance departments, Medical Directors, Medical Staff leaders, physicians, payers and review agencies, contracted providers and community resources as well as some contact with case management clients and their families.

Qualifications

Education/Certification/Licensure

HS Diploma

Associates

Bachelors

Masters

Other

Cert/Reg/Licensure

Required

Masters in Nursing, Case Management, Health Administration, or Social Work

National Certification in Case Management (ACM, ANA RN-BC Case Management) within 18 months of hire

RN licensure,

or MSW

Desired

LCSW for SW candidates

or Equivalent Ed/Exp

Experience

  • Acute hospital management in Case Management or Social Work Services required.

  • Leading innovative case management programs and teams.

  • Strong problem resolution abilities and customer relation skills.

  • Planning, leading and organizing the resources of a team.

  • Expertise in utilization management and discharge planning.

  • Analyzing, interpreting and presenting financial utilization data.

  • Leadership experience in case management in a third party administration or managed health care setting preferred.

  • Performance management and effective leadership.

  • Utilizing Lean principles to motivate people and drive change.

Knowledge

  • Knowledge of ACMA, CMSA & NASW Standards of Practice.

  • Knowledge of available health care and community resources.

  • A broad knowledge base of health care delivery and case management within a managed care environment.

  • Comprehensive knowledge of local, state and federal laws, regulations and professional standards affecting case management practice in an integrated delivery system; including but not limited to: CMS, Title 22, CHA Consent Manual, and the TJC.

Skills

  • Excellent verbal and written communication skills.

  • Group presentation design and facilitation skills.

  • Demonstrated ability to develop and manage complex projects.

  • Working knowledge of InterQual criteria .

  • Ability to promote teamwork and to effectively function in teams, both as a leader and as a team member.

  • Ability to interact effectively with key internal and external constituents using collaboration, negotiation and analytical problem resolution skills.

  • Ability to work effectively in a fast paced environment, directing and managing multiple and complex projects.

  • Analytical and mathematical skills.

  • Demonstrated ability to implement continuous quality improvement processes and techniques, including benchmarking and outcomes measurements.

  • Intermediate to advanced PC skills, word processing, spreadsheets and PowerPoint.

  • Ability to promote teamwork and to effectively function in teams, both as a leader and as a team member.

  • Ability to interact effectively with key internal and external constituents using collaboration, negotiation and analytical problem resolution skills.

  • Effective human relations and interpersonal skills necessary to lead the efforts of diverse health professionals to meet program objectives.

  • Ability to work effectively in a fast paced environment, directing services at multiple locations.

  • Analytical and mathematical skills.

  • Demonstrated ability to implement continuous quality improvement processes and techniques, including benchmarking and outcomes measurements.

  • PC skills, word processing, spreadsheets and managed care software programs.

Primary Location: California, Central Valley, Modesto

Organization: Memorial Medical Center, Modesto

Employee Status: Regular

Employee Referral Bonus: No

Benefits: Yes

Position Status: Exempt

Union: No

Job Shift: Day

Shift Hours: 8 Hour Shift

Days of the Week Scheduled: Monday-Friday

Weekend Requirements: Other

Schedule: Full Time

Hrs Per 2wk Pay Period: 80

All qualified applicants will receive consideration for employment without regard to race, color, creed, religion, marital status, sexual orientation, registered domestic partner status, sex, gender, gender identity or expression, ancestry, national origin (including possession of a driver's license issued to individuals who did not present proof of authorized presence in the U.S.), age, medical condition, physical or mental disability, military or protected veteran status, political affiliation, pregnancy or perceived pregnancy, childbirth, breastfeeding or related medical condition, genetic information or any other characteristic made unlawful by local, state, or federal law, ordinance or regulation. External hires must pass a background check/drug screening. Qualified applicants with arrest and/or conviction records will be considered for employment in a manner consistent with Federal, state, and local laws, including but not limited to the San Francisco Fair Chance Ordinance.