What are the responsibilities and job description for the Manager Care Management - Regional Medical Center position at The County of Santa Clara?
Description
The Power of WE: Together, we can make a greater impact. Bringing better care and expanding healthcare services across the community.
Santa Clara Valley Healthcare (SCVH) is the second largest public health care system in California and includes three acute care hospitals, 14 clinics and 60 specialty and sub-specialty services. Our mission is to provide high-quality, accessible healthcare and excellent service to everyone in Santa Clara County.
Santa Clara Valley Medical Center - SCVMC is a full-service tertiary acute care teaching hospital with 699 licensed beds providing a wide range of specialized services, including Rehabilitation, Burn, Trauma, and NICU. SCVMC was ranked by U.S. News and World Report as #6 Rehabilitation Hospital in the nation and #1 in the West and designated as a 2024 High Performing hospital for Maternity Care, Heart Failure, Stroke, Hip Fracture, and Pneumonia.
O'Connor Hospital- O'Connor Hospital (OCH) is a 358 licensed bed acute care facility offering a full range of inpatient and outpatient medical, surgical and specialty programs to residents of Santa Clara County. It was founded in 1889 as one of the first hospitals in the county. OCH has grown significantly over the past five years in both its inpatient volume and its Emergency Department visits. Along with these volume increases other ancillary and clinical departments like imaging, lab, pharmacy, and respiratory have seen growth as well.
St. Louise Regional Hospital- Since 1989, St. Louise Regional Hospital (SLRH) has been caring for the residents in Santa Clara and San Benito Counties, offering a wide range of inpatient and outpatient medical specialties. SLRH has 93 beds, is a Designated Primary Stroke Center, and is the only acute care hospital in the area. Located in Gilroy, SLRH maintains a CALSTAR 2 emergency helicopter base on the premises.
Learn more about Santa Clara Valley Healthcare: https://www.scvh.org/homeand follow us on: LinkedIn | www.linkedin.com/company/county-of-santa-clara/
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Typical Tasks
The following are the duties performed by employees in this classification. However, employees may perform other related duties at an equivalent level. Each individual in the classification does not necessarily perform all duties listed.
- Plans, organizes, and schedules staff to ensure appropriate staffing and caseload distribution to achieve goals of the utilization management plan and safe and timely hospital discharges;
- Coordinates care management services with Nurse Managers to facilitate admissions through expedited patient discharges and patient flow through all phases of hospital care;
- Directs, evaluates, and develops systems and procedures for efficient and effective operations for discharge planning, care management and utilization management;
- Implements defined quality improvement and utilization management programs including, but not limited, to ensuring data collection, analysis of data, evaluation of outcomes and report generation;
- Supervises, orients, directs, evaluates, disciplines, and is responsible for the training of subordinate staff;
- Assesses staff competency and identifies the educational needs of staff as well as the quality of care management services delivered related to expected length of stay standards;
- Coordinates and ensures interdisciplinary care team meetings occur to facilitate discharge planning activities on every inpatient care unit;
- Communicates with staff and reports findings related to compliance with standards for care planning, discharge planning, utilization review, and related standards and regulations;
- Recommends and ensures implementation of corrective action plans for care management and utilization management to achieve planned quality improvements in patient care services;
- Collaborates with physicians, nurses, and other clinical staff to identify opportunities to improve functions related to care management and evaluate the impact of improvement activities;
- Attends bed management and nursing meetings as required;
- Serves as an expert resource and advisor regarding expected length of stay for a targeted diagnosis related group;
- Optimizes utilization of the online care management program;
- Participates as a member of the Nurse Manager leadership team;
- Represents the Care Management Division as assigned and as needed to provide expertise regarding care management and utilization management functions;
- May be assigned as a Disaster Service Worker (DSW), as required*;
- Performs other related duties, as required.
Employment Standards
Sufficient education, training, and experience to demonstrate the ability to perform the above tasks, plus the possession and direct application of the following knowledge and abilities:
Training and Experience Note: The required knowledge and abilities are attained through possession of a Bachelor's degree, preferably in Nursing
or
Possession of a Master's degree in Nursing Administration
AND
Three (3) years of professional experience in utilization review and/or case management or nursing management in a hospital setting. One (1) year of lead or supervisory experience is preferred.
Special Requirements
- Possession of a license as a Registered Nurse issued by the California Board of Registered Nursing prior to appointment and maintenance of the license for the duration of employment in this classification.
- Ability to travel to alternate locations in the course of work. If driving, possession of a valid California driver’s license prior to appointment and the ability to qualify for and maintain a County driver authorization.
As a condition of employment, pursuant to California Government Code Sections 3100-3109 and Local Ordinance, all County of Santa Clara employees are designated Disaster Service Workers (DSWs), including extra help. A DSW is required to complete all assigned DSW-related training, and in the event of an emergency, return to work as ordered.
Knowledge of:
- Hospital organization, operations for emergency and acute care;
- Principles and practices of nursing and patient care services for care management, discharge planning, and utilization management in an acute health care setting;
- Federal and state health care laws and regulations common to the operation of hospitals in California;
- Financial processes of various private and public funding sources;
- Regulations of intermediary agencies pertaining to hospital stay coverage (e.g. Medicare/Medi-Cal);
- Principles and applications of a hospital information system(s) as it relates to care management and utilization review;
- Principles and practices of supervision, staff development, organization, administration, fiscal and program management;
- Criteria for level of care and current standards in medical and nursing practice;
- Available alternative patient services and treatments;
- English usage, style, grammar, punctuation, and spelling;
- Common computer systems and applications.
Ability to:
- Act as a resource to physicians, nurses, and care management staff;
- Keep abreast of, understand, interpret, apply, and implement healthcare laws, rules, regulations, and procedures;
- Evaluate data and statistics and prepare reports;
- Select, train, supervise, develop, evaluate, discipline, and motivate staff;
- Work effectively as a member of a management team in a large health care organization;
- Establish and maintain effective working relationships with those contacted in the course of work, at all levels, including colleagues, the public, and representatives of other agencies;
- Communicate effectively, both orally and in writing, with people of diverse backgrounds and cultures.
