About this position
SUMMARY: Responsible for the day-to-day operations of facility-wide utilization, discharge planning and care coordination.
DUTIES & ESSENTIAL JOB FUNCTIONS: NOTE: Following are the duties performed by employees in this classification. However, employees may perform other related duties at an equivalent level. Not all duties listed are necessarily performed by each individual in the classification.
1. Assists Director in Establishing, implementing and ensuring that care coordination policies, practices and procedures are in accordance with the Joint Commission, Title 22 and other regulatory agencies and overall hospital policies.
2. Conducts and records periodic staff meetings, to inform staff of changes in policies and procedures.
3. Conducts interdepartmental team conferences for identifying aberrant utilization; establishes a method of tracking variances based on critical timelines.
4. Develops and provides statistical Care Coordination information and reports to appropriate committees and in conjunction with the Director of Care Coordination identifies utilization issues affecting the quality of patient care.
5. Direct and coordinate data gathering and record keeping legally required by Federal and State agencies, the Joint Commission, and hospital policies; participates in the risk mitigation, process of implementing new or revised processes, and projects.
6. In conjunction with VP and Director, coordinates, develops, and implements action plans to respond to areas felt to be in need of improvement related to patient flow and care coordination across the continuum.
7. Manages and assumes responsibility for day-to-day operations of, care coordination and discharge planning activities.
8. Oversees submission of any audits, including but not limited to MediCal, Medicare and internal compliance studies.
MINIMUM QUALIFICATIONS:
Preferred Education: Master’s in Nursing or Masters in Social Work or related field.
Preferred Licenses/Certifications: Certification in Case Management, CCM or ACM.
Required Experience: Five years of clinical nursing or social work experience in a directly related setting (e.g., acute care, skilled nursing, etc.); three years of case management experience; two years of experience in a supervisory or lead role.
Required Licenses/Certifications: Active licensure as a Registered Nurse in the State of California or licensed in Clinical Social Work in California, Active BLS - Basic Life Support Certification issued by the American Heart Association. Must obtain ACM or CCM within a year of the date of hire.
The pay range for this position reflects the base pay scale for the role at Alameda Health System. Final compensation will be determined based on several factors, including but not limited to a candidate’s experience, education, skills, licensure and certifications, departmental equity, applicable collective bargaining agreements, and the operational needs of the organization. Alameda Health System also offers eligible positions a generous comprehensive benefits program.