Director of Care Management- RN
Montage Health’s application process has changed effective 12/20/2019.
If you submitted an online application prior to 12/20/2019, you will be required to recreate your profile information if you want to apply to any new positions. You will no longer have access to your previously saved profiles and applications. Current employees applying for transfer into a posted position must also create a profile.
- Excellent Pay and Generous Benefits including a Pension and Continuing Education Reimbursement
- Excellent Team Orientated Culture
- Free Gym for Employees
Purpose of Position
The Director of Care Management provides the oversight to ensure the company’s care management and contractual performance objectives are met, programs and resources are used effectively and successful execution of both short term and long term care management company goals. The Clinical Program Manager is responsible for leading, developing, and operationalizing care management education, communication and quality improvement activities for the clinical team. This position assesses individual and group competencies and performance using best practice standards and NCQA Care Management criteria, and assists with developing the documentation tools to create impactful standard work.
- Leads and supervises the Aspire clinical teams by demonstrating the capacity and expertise to operationalize best practice recommendations, system goals and regulatory requirements.
- Establishes a culture of excellence in performance and innovation that optimizes opportunities to create new models and processes that better serve patients and their families.
- Responsible for recruitment and staff oversight, including performance evaluations of clinical staff. stablishes and monitors metrics and benchmarks to drive improvement and raise awareness that promotes individual growth and collective improvements in care.
- In conjunction with Aspire leadership, identifies the tools and systems needed to support care management activities.
- Develops and maintains a comprehensive education and training program for care management team, inclusive of case review and case study
- Performs individual and group competency assessments of clinical knowledge, workflow knowledge and systems skills and assists with motivating and teaching team to excel. This includes periodic review of employee chart documentation to ensure compliance to best practice and standards.
- Uses the latest and most innovative evidenced-based training strategies-as well as clinical knowledge to develop and deliver orientation and training materials in a variety of methods including presentation materials, manuals, support materials, case studies, etc.
- Oversees the onboarding and orientation of all new care management department new hires including assignment of preceptors, orientation calendar and scheduling of relevant experiences.
- Works with Aspire's leadership to continuously evaluate quality and performance to identify issues and propose process improvement strategies.
- Performs other duties as assigned.
- Problem Solving and Decision Making: Identifies, analyzes, organizes, and solves problems and issues in a timely, effective manner; uses data and input from others to make sound, timely decisions even in the face of uncertainty.
- Integrity: Consistently honors commitments and takes responsibility for actions and words.
- Flexibility: Demonstrates adaptability and openness to alternative solutions and flexibility when interacting with others, understanding their attitudes, needs, interests, and perspectives.
- Leadership: Leads and motivates others, fosters teamwork, encourages critical-thinking, provides clear and consistent direction and provides staff with growth and development strategies.
- Inclusiveness: The ability to network and partner with all internal and external stakeholders including broad and diverse representation of private/public and traditional/non-traditional community organizations.
- A minimum of five years experience as a registered nurse and two years in care/case management leadership role.
- Current CA RN license.
- Bachelors of Science degree, Masters preferred in Nursing, Public Health, or related field or equivalent combination of experience and education.
- Ability to analyze and integrate information and make sound decisions based upon established guidelines.
- Commitment to the creation of a collaborative and supportive work environment.
- Thorough understanding of health plan and regulatory rules, managed care, care management, disease management and referral processes.
- Highly self-motivated, organized and detailed oriented with an attitude for continuous improvement.
- Proven success in teambuilding and training / coaching staff to meet operational requirements and goals.
- Must be able to prioritize, plan, and handle multiple tasks/demands simultaneously.
- Highly professional with excellent written and verbal communication skills
- Proficient with computer software programs, including Microsoft Word, Excel and Electronic Health Records.
- Knowledge of implementing and evolving healthcare information technology systems to support operations
- Physician Practice management/operations experience.
Assigned Work Hours:
Full time exempt