Director, Care Management (On-Site) Job Listing at NorthBay Healthcare in Fairfield, CA (Job ID 3913)

Description

At NorthBay Health, the director provides oversight for all aspects of Care Management and Population Health which includes: Utilization Management, Utilization Review, Inpatient, Outpatient and Complex Case Management, Discharge Planning, Denial Management, and Social Services. This director will collaborate with Quality and Operations leadership to support key Population Health quality measures. The Director in collaboration with the Chief Quality Officer establishes overall direction for the above areas and implements policies, processes and procedures in support of these programs. They provide direct supervision to personnel and they are responsible for program development, documentation compliance, and compliance with health plan requirements. 

In collaboration with the Chief Quality Officer they will support strategic direction; identifies key measures of success (e.g. length of stay and readmission rates), and implements key processes to maximize efficiency of resource utilization. They will assume overall responsibility for coordinating/managing patient centered care activities for patients within the context of these functions.  They will ensure cost effective and quality patient outcomes through the supervision of clinical/professional staff, collaboration with medical staff, nursing, and support staff. They will operate from an expert knowledge base of UM and Case Management and ensures compliance with state/federal and other regulatory and accreditation body requirements. 

At NorthBay Health, our vision is to be the trusted healthcare partner of choice for the communities we serve. We are dedicated to improving the well-being of our community by providing accessible, high-quality care to all who need it. Every member of our team plays a vital role in delivering compassionate and effective healthcare solutions. We invite you to join us in our mission to ensure that every patient and family member feels valued, respected, and cared for throughout their healthcare journey.

PRIMARY JOB DUTIES

Provides leadership and direction and sustains a leading edge environment that supports excellence and innovation in Population Health and Care Management through assessing, planning, implementing and evaluating programs and standards that support high quality, patient-centered outcomes including the following:

• Develop strategies working with the VP of Population Health, to improve the health outcomes of the population served by the health system. 
• Work closely and collaborate with the quality team, clinical leadership and operations to develop a centralized approach for initiatives in support of enhancing and maintaining performance on quality measures; this includes HEDIS, other chronic and preventative measures, cost and utilization measures; Support development of best practices related to care gap closure.
• Track population health data to identify trends, disparities, and areas for improvement. Generate reports and dashboards to communicate key findings and measure progress toward population health goals.
• Collaborate with community organizations, local government agencies, and other stakeholders to address social determinants of health and improve access to healthcare services for the populations we serve.
• Identify, trend and leverage patient data including Social Determinants of Health to support effective and intensive Population Health and Care Management intervention;
• Assess and identify appropriate resource utilization, level of care and treatment options including a discharge plan of care that impacts quality outcomes in a cost effective manner;
• Collaborate with members of the healthcare team to promote quality care, prevent complications, and ensure smooth transitions to appropriate levels of care.
• Guide and direct Case Management care plans that are developed with patient and physician (and others as appropriate) to meet the patients' needs and avoid duplication and/or fragmentation of services
• Lead liaison support to post-hospital care providers and community health resources;
• Monitor response by patient to the services/products provided
• Ensures that patients and their families that are high risk for psychosocial/environmental negative impacts, receive timely and competent social services interventions.

Education: Baccalaureate Degree in nursing or a health care related field required. Master's Degree required.

Licensure/Certification: California Nursing License required. Certification in the area of Case Management required within 6 months of hire. 

Experience: Three to five years of related clinical experience in area of responsibility. A minimum of 3 years of director level experience in Case Management and Population Health strongly preferred. 

Skills: Demonstrated initiative, follow through and ability to work independently.  Demonstrated results oriented management. Demonstrated effective project management skills. Excellent written and verbal communication and presentation skills. Must be able to deal with job-related stress, multiple projects and deadlines. Advanced computer skills (spreadsheets, graphs, tables and reports).

Interpersonal Skills: Demonstrates the True North values. The True North values are a set of value-based behaviors that are to be consistently demonstrated and role modeled by all employees that work at NorthBay Health. The True North values principles consist of Nurture/Care, Own It, Respect Relationships, Build Trust and Hardwire Excellence. 

Compensation: $210 to $230 based on years of experience doing the duties of the role.