Vice President, Case Management job at Dignity Health Corporate Office in San Francisco

Dignity Health Corporate Office is at present recruited Vice President, Case Management on Wed, 06 Nov 2013 03:24:44 GMT. Vice President, Case Management ( Job ID : 1300017006... Care Management About This Position JOB SUMMARY The VP, Case Management (CM) will be responsible for the oversight of Case Management (CM) practice in Dignity Health hospitals and will be instrumental in implementing changes in programs and work practices that result from these initiatives. This oversight with be conducted with...

Vice President, Case Management

Location: San Francisco California

Description: Dignity Health Corporate Office is at present recruited Vice President, Case Management right now, this job will be placed in California. More details about this job opportunity kindly see the descriptions. (

Job ID

:

1300017006

)

-

Care Management

About This Position

JOB SUMMARY

The VP, Case Managem! ent (CM) will be responsible for the oversight of Case Management (CM) practice in Dignity Health hospitals and will be instrumental in implementing changes in programs and work practices that result from these initiatives. This oversight with be conducted with the goal of standardizing CM policies, practices, workflow and data reporting within the system, while maintaining quality patient care and adhering to all relevant compliance activities.

The new VP, CM will lead the system’s CM Leadership Council, comprised of Hospital CM Directors, Service Area CM Directors and physician leaders (e.g., Physician Advisors) as applicable.

S/he will play a key role in supporting the system’s CM departments comprised of 40 local and regional CM Directors, and will work closely with the CM leaders to move a very large and complex system toward a single practice structure and build better connections between system level compliance and operational initiatives at the! local and regional levels.

The VP, CM will also work! with CM and Nursing Leadership, specifically Dignity Health Chief Nurse Executive (CNO) and facility CNOs, on issues involving CM and patient care services related to Clinical Operations Improvement (COI), Discharge Planning and Utilization Management. Similarly, the VP, CM will work closely with local Chief Financial Officers (CFOs) who currently supervise CM at their hospitals. The VP CM will play a key role and collaborate with Optum 360 to ensure an efficient and compliant revenue services program.

ESSENTIAL FUNCTIONS

1. Work with hospital leadership and affiliated physicians to build and lead a comprehensive Case Management program implemented consistently and compliantly throughout the organization.

2. Provide leadership for CM Directors to participate in a major redesign effort to improve the process for case management in keeping with the principles of patient-focused care (in a managed care environment) during a time of rapid change.
3. Establish utilization review revenue goals in collaboration with Chief Financial Officers.

4. Collaborate with CM Directors and staff (as appropriate) in alterations of job responsibilities.

5. Ensure that all actions taken and methods used to produce desired results incorporate and promote the Mission and Values of Dignity Health.

6. Provide overall direction for the activities and functions of the CM Departments in an efficient and cost-effective manner to improve quality patient care, reduce costs and increase the degree of system integration.

7. Develop trust, cooperation, and collaboration with administrative medical staff and departments across the system.

8. Maintain effective communication with internal and external customers to coordinate and adequately address patient care needs.

9. Review data for trends and analyze the impact on department operations.

10. Work with Optum360 to ensure an effe! ctive and compliant Clinical Documentation Improvement program.
11. Implement improved utilization management systems to decrease inappropriate admissions, excessive length of stay and medical necessity denials; respond to regulatory changes (e.g., Two Midnight Rule).

12. Develop utilization targets in collaboration with system physician and nursing leadership.

13. Help build and support a comprehensive regional CM program that meets the requirements of JCAHO and other licensing and accrediting agencies.

14. Provide accurate and pertinent information to appropriate departments, administration, medical staff, and others involved with CM activities.

15. Conduct educational programs for CM, staff physicians and hospital leadership related to CM and Clinical Operations Improvement (COI).

QUALIFICATIONS

Education

  • Bachelor of Science in Nursing (BSN) degree required.
  • Masters degree in Nursing, Health related field, or Public/Business Administration required (at! onset or within 5 years of hiring).
Experience

  • A minimum of five years of progressively responsible management experience is required.
  • Experience in Utilization Review, Case Management and managed care is required.
  • Prior experience leading large scale change initiatives with attention to impacted stakeholders, tracking metrics and sustained improvements preferred.
Training/Specific Knowledge

  • Management theories and practices
  • Knowledge of Case Management
  • Knowledge of CQI principles and tools
  • Healthcare systems, processes, and organization
  • Principles of hospital finance and budgeting
  • JCAHO, state, and federal regulations affecting or involving Case Management/improvement, infection control, and utilization review
  • Theory and practice of human resource management.
  • Understand managed care and capitation principles.
  • Third party reimb! ursement, including Medicare, Medi-Cal, and capitation
  • Evolvin! g clinical practices and case management models
  • Managed Care rules, regulations and medical group operations
  • Impact of managed care on utilization of resources
  • Financial Reporting
  • Integrated QI, Risk management, Utilization Management and Infection Control mode
  • CHA Consent Manual
  • Fire and safety regulation
  • Health and accident insurance programs
Special Skills

  • Demonstrated competencies and attributes related to understanding of Humankindness and it’s importance in patient and employee experience
  • Analytical, problem solving and decision making abilities
  • Creative and innovative thinking abilities
  • Ability to plan, establish, and accomplish objectives.
  • Effective oral and written communication skills
  • Interpersonal relationship skills
  • Initiative and flexibility
  • Ability to organize work and facilitate group processes
  • A! bility to work effectively with the management team, employees, physicians, patients, and families
  • Ability to motivate others to make changes
  • Ability to identify opportunities for improved reimbursement
  • Operation of personal computer and related software
  • Ability to plan, execute and manage multiple department budgets
  • Ability to develop policies and procedures
  • Ability to establish and maintain effective working relationships with numerous departments and individuals
  • Ability to effectively prioritize work projects and work independently
Licensure

  • Current California Registered Nurse license required
Travel Requirement :
50%

About Us

About Dignity Health

Dignity Health, headquartered in San Francisco, Calif., provides integrated, patient and family centered care. It is the fifth largest health system in the country with 10,000 physicians a! nd 55,000 employees across Arizona, California, and Nevada. Through its! network of more than 150 ancillary care sites and 40 acute care hospitals, Dignity Health is committed to delivering compassionate, high-quality, affordable health care services with special attention to the poor and underserved. In 2011, Dignity Health provided $1.4 billion in charity care, community benefit and unreimbursed patient care. For more information, please visit our website at

www.dignityhealth.org

. Dignity Health is also on Facebook and Twitter.

Organization

:

Dignity Health Corporate Office

Primary Location

:

California-SF Bay Area Service Area-San Francisco-Corporate Office - SF

Work Locations

:

Corporate Office - SF

185 Berry St Suite 300

San Francisco

94107

Hours Per Pay Period

:

80

Shift

:

Day

Employment Type

:

Full Time

Work Schedule
:

8HOUR

Number of Openings

:

1

Area of Interest

:

Case Management / Utilization Review
- .
If you were eligible to this job, please email us your resume, with salary requirements and a resume to Dignity Health Corporate Office.

If you interested on this job just click on the Apply button, you will be redirected to the official website

This job starts available on: Wed, 06 Nov 2013 03:24:44 GMT



Apply Vice President, Case Management Here

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