Director of Clinical Case Management (RN)

AMI Network Inc; Irvine (CA); On-site; USD 150,000 - 160,000; Full time

Benefits offered by this job

Generous PTO

401k matching

Comprehensive Medical/Dental/Vision plans

Job summary

A leading healthcare organization is seeking a Director of Clinical Case Management (RN) to lead complex case management and ambulatory clinical operations. The ideal candidate will be a Registered Nurse with substantial background in managed care, responsible for overseeing teams while ensuring quality patient care. The position offers competitive benefits, including generous PTO and 401k matching, while contributing to community health.

Qualifications

• Licensed Registered Nurse (RN) in CA with 3+ years nursing leadership experience.
• 3+ years related managed care experience required.
• 1+ year experience with Medicare or ACO population preferred.

Responsibilities

• Oversees clinical operations and develops clinical management teams.
• Designs performance improvement initiatives and collaborates on patient care processes.
• Works with stakeholders to measure success and improve care management.

Skills

Clinical Leadership

Managed Care

Care Coordination

Patient Care Management

Education

Bachelor's Degree or higher

Job description

Director of Clinical Case Management (RN)

• Full-time

We are partnered with one of the largest non-profit healthcare delivery systems inOrange Countysearching for a Director to overseecomplex case management and ambulatory clinical operationsfor their ACO / Medicare population.

The ideal candidate will be aRegistered Nursewith a strong managed care background and an in-depth understanding of ACO and Medicare guidelines.

This company really takes care of both it's patients and it's employees. They constantly give back to the community, and they offer a generous amount of PTO, 401k matching, and great Medical/Dental/Vision plans to every full-time employee.

Salary:$150,000 - $160,000 a year

Schedule:Mon-Fri 8am-5pm (on-site)

Job Duties:

• Oversees the clinical operations of the care management team, including hiring and developing Clinical Management, Nurse Case Managers, and Social Workers
• Ensures cost effective and quality transition of care through the utilization of appropriate resources.
• Designs and Implements performance improvement initiatives within scope.
• Coordinates activity with post-acute and ambulatory care transition teams to create a patient-centric process, in alignment with system hospitals.
• Develops strong relationships with physicians, physician leaders and other providers regarding the flow of patient care within the system.
• Collaborates assesses and makes recommendations to leadership to identify opportunities for improvement in patient care management and optimal process and resource utilization.
• Works with key stakeholders to determine metrics for success.
• Provides information and analysis of performance measurement - identifies better practices to scale within the system.
• Develops and deploys team-based care paths that extend and complement the network physician providers.

Requirements:

• 3+ years' experience in a nursing leadership position
• 3+ years of related managed care experience (Case Manager, Care Manager, Case Management, Care Management, Utilization Review, Utilization Management, Care Coordination, etc.)
• 1+ year working with a Medicare or ACO population
• Licensed Registered Nurse (RN) in CA
• Bachelors Degree or higher education is preferred but not required

Salary range is an estimate.

Job Type: Full-time

Experience:

• ACO: 1 year
• Case Management: 1 year

Education:

• Bachelor's

License:

• RN
• 3+ years' experience in a nursing leadership position
• 3+ years of related managed care experience (Case Manager, Care Manager, Case Management, Care Management, Utilization Review, Utilization Management, Care Coordination, etc.)
• 1+ year working with a Medicare or ACO population
• Licensed Registered Nurse (RN) in CA
• Bachelors Degree or higher education is preferred but not required

All your information will be kept confidential according to EEO guidelines.