RN Manager, Clinical Case Management - Full Time, Days

Southern California Hospitals; Culver City (CA); On-site; USD 150,000 - 189,000; Full time

Job summary

Southern California Hospitals seeks a Manager of Case Management to oversee daily operations of the Case Management Department, ensuring regulatory compliance and collaboration with physicians and medical directors. The role reports to the Director of Case Management and includes coaching, training, hiring, and payroll processes while analyzing data and completing reports.

Responsibilities include strategic plan implementation, committee support, and ensuring resource utilization and LOS goals

Qualifications

• California RN license is required.
• 2 years of leadership in Acute Care Case Management.
• Excellent verbal and written communication skills.
• Computer literacy.
• Knowledge of Federal, State and Local regulatory standards.
• Professional demeanor with healthcare team.
• Strong organizational and time management skills.
• Demonstrated leadership skills.

Responsibilities

• Assist Director of Case Management to implement strategic plans, monitor budgets, ensure policies comply with regulations, and allocate resources for performance improvement.
• Assist in Utilization Management Committee by compiling subject matter and validating with the Director prior to meetings; ensure data accuracy and plan effectiveness.
• Collaborate with clinical and administrative leadership to meet service expectations and length-of-stay goals; improve resource utilization and information exchange.
• Create a safe work environment, manage hiring/training/evaluations/discipline, and provide leadership across assigned locations.

Skills

Leadership

Communication

Time management

Computer literacy

Regulatory knowledge

Prioritization

Interpersonal skills

Education

RN License - California

BSN

CCM Certification

InterQual/MCG knowledge

Tools

InterQual/MCG knowledge

Job description

The Manager of Case Management is accountable for overseeing all aspects of daily operations of the Case Management Department. Ensures standards of operations are in accordance with all state and federal healthcare regulatory guidelines. Works closely with Physician Advisors and Medical Directors assigned to the Facility(s). Attends the Utilization Management Committee. Under the direction of the Director of Case Management is responsible for employee coaching, training, hiring, counseling/discipline, performance assessment and payroll processes. Completes reports and analyzes data as assigned.

Position Summary

The Manager of Case Management is accountable for overseeing all aspects of daily operations of the Case Management Department. Ensures standards of operations are in accordance with all state and federal healthcare regulatory guidelines. Works closely with Physician Advisors and Medical Directors assigned to the Facility(s). Attends the Utilization Management Committee. Under the direction of the Director of Case Management is responsible for employee coaching, training, hiring, counseling/discipline, performance assessment and payroll processes. Completes reports and analyzes data as assigned.

Responsibilities

• Assists Director of Case Management to implement strategic plans, unit/department goals and objectives, business initiatives, and to monitor financial plans and budgets. Complies with all policies/procedures, applicable laws and regulatory agency requirements, and organization work standards. Assumes responsibility for management decisions determined within the scope of this job description. Maintains records in compliance with legal and regulatory requirements. Demonstrates strategic and critical thinking; makes optimal use of resources; allocates and prioritizes work monitoring performance standards for continuous performance improvement.
• Assists to compile subject matter under the direction of the Director of Case Management for the Utilization Management Committee. Appropriately monitors and validates subject matter with the Director of Case Management prior to meeting. Ensures that avoidable and variance days are collected appropriately by case management staff. Verifies that the Directors of Case Management action plan is put in place, and goals are set, communicated, and met.
• Collaborates effectively with clinical and administrative leadership, physicians, nurses and a wide variety of other staff to ensure that service expectations and length of stay goals are met. Works with Director of Case Management to improve resource utilization, service delivery, work flow, etc. as necessary to meet established expectations. Ensures prompt and proper information exchanges and issue resolution. Appropriately informs Director of Case Management of issues needing immediate attention.
• Creates a safe work environment that fosters respect and positive morale. Effectively allocates and evaluates department work, and provides leadership and appropriate follow through to the Department. Effectively communicates with all staff. In cooperation with the Director of Case Management, interviews applicants and manages the hiring, firing, training, annual performance evaluations and competencies, and disciplinary process at assigned locations.

Required Qualifications

• Current Licensure as a Registered Nurse in the State of California
• Two (2) years of leadership experience in Acute Care Case Management
• Excellent verbal and written communication skills
• Computer literate
• Knowledge of all Federal, State and Local regulatory standards
• Professional demeanor with Healthcare team
• Strong Organizational and Time Management skills with ability to effectively prioritize tasks
• Demonstrated Leadership Skills

Preferred Qualifications

• BSN
• InterQual or MCG criteria knowledge
• Certified Case Manager (CCM) or other Case Management/Nursing Certification

Pay Rate: Min - $150,000 | Max - $188,775

Salary: $137300 - $188775 per year