If you are looking for a Stable Hospital Organization, an affordable area to live, a generous compensation package and able to drive to San Francisco within a short commute, this position could be for you! If qualified, please apply immediately.

Overview:

Director of Managed Care is responsible and accountable for clinical and financial operations of a Care Management system.

Director provides hospital-wide leadership through effective managerial and educational direction in the areas of Care Management Operations, Resource Management, and timely movement of patients through a continuum, DRG Financial Analysis, Change Management, Managed Care, Guidelines/Protocols, Clinical Documentation and Systems Improvement.

Designs, implements and continually improves clinical systems for reducing and/or controlling length of stay, costs and/or resource consumption ensuring maintenance or improvements in patient outcomes.

Director of Managed Care is accountable for the ongoing operations and direct impact of the Care Management system as it relates to cost and quality.

Qualifications:          

 Education:

¹  BSN

¹  Masters Degree in Nursing, Health Administration or Business Administration.

  Experience:

¹  Requires a minimum of three (3) years recent acute care experience. Five years demonstrated experience as a Director/Manager of Care Management in a fast paced, complex environment.

¹  Multidisciplinary approach to clinical improvement.

¹  Fiscal Management of Dept. operations.

¹  Managed Care concepts and strategies; DRG reimbursement system.

¹  Capable of converting DRG and Physician Practice pattern data into information which quantifies impact on cost and quality.

¹  Ability to implement new programs and problem-solving mechanisms.

¹  Good communication/analytical/writing skills.

¹  Excellent knowledge of Medicare/Medicaid and Third Party admission and concurrent review criteria.

¹  Knowledge of “benchmarking” and “best practice” methodologies.

¹  Ability to implement and initiate workload changes and set priorities accordingly.

Licenses/Certificates:          

¹        Current California Registered Nurse License

¹        Current BLS Certification through AHA

Competitive SalaryRange +Relocation +Sign-on

Client will interview quickly!