Vice President of Case Management in Corporate at Alta Hospitals System

Date Posted: 9/9/2020

Job Snapshot

  • Employee Type:
    Full-Time
  • Location:
    3415 South Sepulveda Boulevard
    Corporate
  • Experience:
    Not Specified
  • Date Posted:
    9/9/2020
  • Job ID:
    16549

Job Description



Vice President of Case Management 

We are hospitals and affiliated medical groups, working closely together for the benefit of every person who comes to us for care. We build comprehensive networks of quality healthcare services that are designed to offer our patients highly coordinated, personalized care and help them live healthier lives. Through collaboration, we strive to provide all of our patients and medical group members with the quality, affordable healthcare they need and deserve.

The Vice President, Case Management is responsible for setting the strategy for Case Management for the California Region.  Leads the development and oversees the development and execution of policies and procedures, practices workflow, and data reporting for the California Region. Directing the standardization of CM policies, practices workflow and data reporting within the system. Maintains quality patient care and adheres to all relevant compliance activities. Develops trust, cooperation, and collaboration with administrative, medical staff and departments across the California Region.



Job Responsibilities/Duties

  • Oversees and ensures that day to day Case Management operations of the California Region are completed in an efficient manner and in accordance with organizational policies and values.  Demonstrates problem-solving, critical thinking, and prioritization of work and resolves issues as they arise in an appropriate and timely manner. Develops and executes on short- and long-term goals for the department consistent with established hospital/organization goals and objectives.
  • Coordinates the education and training of all case management staff across the Southern California region.  Plans and ensures completeness and appropriateness of training material.  Procures and deploys educational resources to offer continual support to hospital staff on MCG and Allscripts proficiencies.   Ensures MCG IRR proficiency level of 95% or better for all case managers, including directors and managers.
  • Coordinates regional staffing efforts across the region utilizing IHR incentives.  Leads this effort on a day-to-day basis by accessing each facilities’ schedules and real-time information on unexpected staffing gaps such as call offs.   Communicates to all case managers (and directors) asking for their assistance to fill these staffing gaps across the region.  Ensures all qualifying IHR incentives are properly coded and paid. 
  • Contributes at the most senior level by working across strategic and business units to set, engage and achieve objectives of the organization.  Demonstrates the ability to critically evaluate and provide input to areas outside own area of expertise.  Acts as a coach and positive role model for staff by establishing and maintaining a safe work environment that fosters positive morale.  Provides guidance and support to director/manager/supervisor/staff as needed.


Qualifications

Minimum Education: High School Diploma. Bachelors or Masters of Science in Nursing preferred.

Minimum Experience: Ten (10) years of experience in an Acute Care Case Management/Utilization Review role, with at least three (3) years in a director level role. Knowledge of standard utilization screening tools such as MCG and InterQual. Experience with Case Management EMR Systems such as, Midas, Cerner and/or Allscripts Care Manager. Knowledge of DRG, Value Based, Risk Based and Per Diem payment methodologies. Knowledge of all Federal, State and Local regulatory standards. Computer literacy and proficiency. Professional demeanor with Healthcare team. Strong Organizational and Time Management skills with ability to effectively prioritize tasks.

Req. Certification/Licensure: Current Licensure as a Registered Nurse in the State of California. Certified Case Manager (CCM) or other Case Management/Nursing Certification preferred. Lean Six Sigma Certification preferred.



Employee Value Proposition

Prospect Medical Holdings, Inc., is guided by a diverse and highly experienced leadership core. This group maintains the vision that has made Prospect a needed difference-maker in the lives of so many patients today, and many executives contribute to our continued efforts. As a member of our highly effective team of professionals you will receive:

  • Company 401K
  • Medical, dental, vision insurance
  • Paid time-off
  • Life insurance


How to Apply

To apply for this role, or search our other openings, please visit http://pmh.com/careers/ and click on a location to begin your journey to a new career with us!

We are an Equal Opportunity/ Affirmative Action Employer and do not discriminate against applicants due to veteran status, disability, race, gender, gender identity, sexual orientation or other protected characteristics. If you need special accommodation for the application process, please contact Human Resources.

EEOC is the Law: https://www1.eeoc.gov/employers/poster.cfm

Keywords: VP, Hospitals, Healthcare, Leadership, Case Management, MCG, InterQual, EMR, Midas, Cerner, Allscripts, Care Manager, DRG, Reporting, Training.



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