Regional Nurse Program Coordinator
Location: San Diego California
Description: Blue Shield of California is at present looking to employ Regional Nurse Program Coordinator right now, this occupation will be placed in California. Further informations about this occupation opportunity please read the description below. The Regional Nurse Program Coordinator (RNPC), who will report to a nurse manager, works in partnership with the Regional Medical Director (RMD! ) and/or the Accountable Care Organization (ACO) Medical Director, the Regional Program Manager, and regional network management and provider relations staff (the Regional Delegation Team) to achieve the Blue Shield of California (BSC) strategic goals of reducing inpatient bed days per thousand, achieving affordability, and improving quality of care. The RNPC/RMD relationship is analogous to the Advanced Practice Nurse/MD relationship.
The RNPC will be responsible for:
Teaching/mentoring medical groups and hospital care management staff in the following:
- UM (inpatient and outpatient)
- Complex case management
- ER interventions
- Pharmacy
- Gathering and interpreting data
- Process and performance improvement
- RN will provide onsite presence to medica! l groups and associated hospitals that have been identified as! having excessive avoidable bed days. The onsite RN will provide concurrent review and case management support to the groups and hospitals in order to eliminate avoidable bed days.
- In coordination with the RMD and Program Manager, assess:
- Medical groups’ will and skill, readiness to change, and existence of appropriate infrastructure to support care management best practices
- Management/monitoring of progress of medical groups on corrective action plans
- In coordination with RMD and Program Manager, work with medical groups & hospital clinical staff to design, implement, and evaluate new programs and best practices
Bachelor of Science in Nursing (BSN) required. Master’s level preparation desirable
5 years clinical experience required
3 or more years experience in utilization management
3 or more years e! xperience in hospital, group, or health plan care management
2 or more years experience working in care management team
Prior management experience preferred
Prior experience in IPA/Medical Group delegation oversight strongly preferred
Demonstrated proficiency with Excel, Word, and PowerPoint
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Blue Shield of California is committed to remaining a drug-free work place. All positions require a pre-employment background investigation and drug screen. Blue Shield of California is an Equal Opportunity Employer.
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If you were eligible to this occupation, please email us your resume, with salary requirements and a resume to Blue Shield of California.
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This occupation starts available on: Sat, 09 Mar 2013 01:18:42 GMT