Position: Manager Case Management RN
About: The Manager of Care Management will supervise and direct all levels of Care Management team that includes RN Care Managers, Lead Care Management RN, Care Management Coordinators, Discharge Planners, Care Coordinators, and Care Management Educator. This position oversees assessment of patients, admission appropriateness, discharge assistance, and post-care follow-up in collaboration with the ED care management team and Social Work Department. Additionally, responsible for managing clinical supervision, scheduling, payroll, coaching, corrective action, educational needs, electronic referral systems, and documentation of care management through Cerner Healthcare EMR. Oversees post-acute providers, facilities, compliance policies, and plan-related vendor networks. Collaborates within the Population Health Program and shares Care Management Leadership Call duties on a rotation basis.
Requirements: A. Education: Bachelor’s degree in nursing required; Master’s degree in related area preferred. B. Qualifications/Experience: Five (5) years acute care hospital, health plan, and/or ancillary services required; Supervisory or Management experience in a clinical role required; RN license required; CCM or ACM certification required within 2 years of hire; BLS certification; Workplace violence prevention training annually; Direct patient care or care coordination, utilization, case/disease management experience a plus; Experience with Medicaid/Medi-Cal patients and government programs preferred; Experience in clinical health informatics preferred. C. Special Skills/Knowledge: Significant knowledge regarding health care provider organizations – acute and post-acute care facilities and providers; Working knowledge of health plans and typical UM and medical management functions.
