Nautilus Evolutions INTERIM Executive Director of Care Coordination Opportunity |
"Real Leaders Are Ordinary People with Extraordinary Determination"
NAUTILUS EVOLUTIONS, LLC supports the Interim Candidate needs for multiple organizations and clients.
If you are interested in a specific position, please complete the following questionnaire. This information will provide an initial approach toward matching your interest with the client needs and requirements for this opportunity.
Section #2 below allows you to upload your current resume. If there are any issues with this process, it can also be emailed directly to nita@nautilus-e.com
Once we have received your information, we will contact you to discuss this current interim leadership need.
If you are interested in a specific position, please complete the following questionnaire. This information will provide an initial approach toward matching your interest with the client needs and requirements for this opportunity.
Section #2 below allows you to upload your current resume. If there are any issues with this process, it can also be emailed directly to nita@nautilus-e.com
Once we have received your information, we will contact you to discuss this current interim leadership need.
DETAILS REGARDING THIS SPECIFIC INTERIM OPPORTUNITY:
INTERIM EXECUTIVE DIRECTOR CARE COORDINATION
Location: Northern California
Job Description:
Under the direction of the Vice President of Care Management, manages the day to day operations of Care Management across all multiple facilities and Care Transition programs.
Key Qualifications:
Required Education: Master’s degree in Nursing or Master’s degree in Social Work
Required Experience: Seven to ten years of case management or quality experience and progressive management leadership experience in a large healthcare organization required.
Required Licenses/Certifications: Active licensure as a Registered Nurse in the State of California or valid license as a Clinical Social Worker issued by the State of California Board of Behavior Science Examiners;
Active Basic Life Support Certification
CPI -Crisis Prevention Intervention Training
Preferred Licenses/Certifications: Certification in Case Management, CCMC or ACM.
Fluency in the compliance and regulatory standards governing health plans and patient care.
Knowledge of the Nurse Practice Act, TJC, DMHC, CMS, NCQA, HIPPA, ERISA, EMTALA & all other applicable federal/state/local laws & regulations
Exceptional interpersonal skills required for connecting with patients and their families as well as successfully interacting with colleagues, internal physicians and staff, referring physicians and community organizations.
Knowledge of standardized Interqual® or Milliman Care Guidelines.
Experience with Electronic Health Record (EHR) and Case Management applications, e.g. Midas or3M.
Knowledge of program planning and evaluation techniques and strategies.
Key Responsibilities:
Accountable for Patient Care Coordination activities including system-wide Case Management, Care Coordination and Discharge Planning.
Aligns Case Management with organizational strategic and operational objectives.
Optimizes efficient Care Management/care coordination roles and processes; initiates process improvements.
Develops, monitors and evaluates inpatient Care Management Metrics; manages the collection, analysis and presentation data relevant to the utilization of healthcare resources including but not limited to avoidable/variance days, readmissions, one-day stays, DRGs, LOS.
Develops, maintains and implements Case Management policies, practices and procedures in accordance with CMS, CA DCHS, the Joint Commission, Title 22 and other regulatory agencies and overall hospital policies; integrates managed care contract criteria into overall Case Management functions.
Works closely with the VP of Care Management and Physician Advisors on any audits and secondary reviews; may include but not limited to Direct and coordinate data gathering, chart audits and participants in internal and external meetings.
Oversees educational needs and plan for inpatient Care Management division.
Recruits, trains and coaches the management staff.
Addl responsibilites to be shared upon inquiry.
Location: Northern California
Job Description:
Under the direction of the Vice President of Care Management, manages the day to day operations of Care Management across all multiple facilities and Care Transition programs.
Key Qualifications:
Required Education: Master’s degree in Nursing or Master’s degree in Social Work
Required Experience: Seven to ten years of case management or quality experience and progressive management leadership experience in a large healthcare organization required.
Required Licenses/Certifications: Active licensure as a Registered Nurse in the State of California or valid license as a Clinical Social Worker issued by the State of California Board of Behavior Science Examiners;
Active Basic Life Support Certification
CPI -Crisis Prevention Intervention Training
Preferred Licenses/Certifications: Certification in Case Management, CCMC or ACM.
Fluency in the compliance and regulatory standards governing health plans and patient care.
Knowledge of the Nurse Practice Act, TJC, DMHC, CMS, NCQA, HIPPA, ERISA, EMTALA & all other applicable federal/state/local laws & regulations
Exceptional interpersonal skills required for connecting with patients and their families as well as successfully interacting with colleagues, internal physicians and staff, referring physicians and community organizations.
Knowledge of standardized Interqual® or Milliman Care Guidelines.
Experience with Electronic Health Record (EHR) and Case Management applications, e.g. Midas or3M.
Knowledge of program planning and evaluation techniques and strategies.
Key Responsibilities:
Accountable for Patient Care Coordination activities including system-wide Case Management, Care Coordination and Discharge Planning.
Aligns Case Management with organizational strategic and operational objectives.
Optimizes efficient Care Management/care coordination roles and processes; initiates process improvements.
Develops, monitors and evaluates inpatient Care Management Metrics; manages the collection, analysis and presentation data relevant to the utilization of healthcare resources including but not limited to avoidable/variance days, readmissions, one-day stays, DRGs, LOS.
Develops, maintains and implements Case Management policies, practices and procedures in accordance with CMS, CA DCHS, the Joint Commission, Title 22 and other regulatory agencies and overall hospital policies; integrates managed care contract criteria into overall Case Management functions.
Works closely with the VP of Care Management and Physician Advisors on any audits and secondary reviews; may include but not limited to Direct and coordinate data gathering, chart audits and participants in internal and external meetings.
Oversees educational needs and plan for inpatient Care Management division.
Recruits, trains and coaches the management staff.
Addl responsibilites to be shared upon inquiry.