Manager, Care Management at Sutter Health in Jackson

Job description

We are so glad you are interested in joining Sutter Health! Organization: SAH-Sutter Amador Hospital Position Overview: Manages the overall operations of the department for Sutter Health entities in accordance with current federal and state regulations and guidelines. Has frequent contact with the Administrative Team, Nurse Executives and Directors, Risk Management & Ethics staff, Ancillary Services, Revenue Cycle and Finance Department leaders, Medical Directors, Medical Staff leaders, physicians, contracted providers, community resources post-acute agencies, patients and their families. Job Description : These Principal Accountabilities, Requirements and Qualifications are not exhaustive, but are merely the most descriptive of the current job. Management reserves the right to revise the job description or require that other tasks be performed when the circumstances of the job change (for example, emergencies, staff changes, workload, or technical development). JOB ACCOUNTABILITIES: Effectively manages the activities of the care coordination team, providing leadership and guidance • Determines staffing levels, interviews, and recommends for hire. • Ensures Orientation, training and competency assessment of staff is performed and documented in a timely and effective manner. • Evaluates staff, counsels and confronts unsatisfactory performance promptly and fairly and administers corrective action. • Identifies department goals and objectives, develops and communicates action plans through regular staff meetings and other communications, uses team approach to problem solving and sets clear expectations. • Identifies training needs and develops and participates in staff training. Provides a challenging, supportive environment and delegates appropriately. Seeks additional training opportunities through outside sources. • Develops monitoring systems and measurements for the Care Coordination team and exhibits a customer service philosophy. Designs, implements and directs Care Coordination processes for effective coordination of health care services to achieve program goals and objectives • Assures all services are in compliance with accrediting, statutory, regulatory and entity-specific standards by implementing and following applicable policies and procedures. • Effectively communicates Utilization Management Program and action plan goals and objectives to the Care Coordination team. Plans activities and strategy to support effective implementation. • Drives vision and direction through effective communication, sharing information, trending data and communicating outcome measurements for the organization. • Organizes and presents the Care Coordination care model to internal and external groups. • In collaboration with management, develops and administers strategic action plans for achieving goals to include patient progression, throughput, access to care and transitions of care barriers. • Assists in preparing accurate and timely operating budgets for Care Coordination operations and monitors and tracks monthly budget goal to analyze budget variances and produce budget variance reports. Manages the operations of the Care Coordination team to ensure cost effective utilization of department resources • Facilitates complex clinical and financial decision making in conjunction with the Director by presenting and escalating cases to senior management requiring administrative approval or intervention. • Works collaboratively with management staff at, Sutter Health and local SNFs to assure that appropriate utilization and LOS goals are met. Facilitates efficient and effective transitions of care to post-acute LOC. • Tracks, analyzes and presents data to leadership and interprets findings and proposes process improvements. • Communicates utilization findings to leadership as requested, via reports, meetings and presentations. • Works with staff in Patient Access, claims and billing departments to resolve complex claims and follows to resol