Manager - Inpatient Case Management
Description
Job Title: Manager - Inpatient Case Management
Department: Health Services - ICM
About the Role:
Manager - Inpatient Case Management (ICM) provides departmental direction for the functions of case management, utilization management, discharge planning, and denial management for all inpatient and post-acute levels of care. Responsibilities include monitoring the delivery of care to patients, the development of strategies to reduce costs and ensure the appropriate utilization of facilities and services and to provide appropriate transition-of-care planning for every patient to return to their optimum level of function.
What You'll Do:
- Oversee the collection, analysis, and reporting of financial and quality data related to utilization management, quality improvement, and performance improvement
- Plan, organize, analyze, develop and implement departmental programs, services and strategies to ensure favorable operating results
- Adhere to all budgetary and productivity goals/standards
- Ensure the attainment of department goals, policies and procedures
- Promotes interdisciplinary collaboration, fosters teamwork, and champions service excellence
- Works in collaboration with discharge planning team to facilitate excellent communication, collaboration and safe transitions in care, post-acute follow up calls and documentation of all communication and physicians orders for post-acute care needs
- Effectively develop and manage CCS coverage for qualifying patients
- Facilitate growth and development of the case management program consistent with the Astrana’s philosophy and in response to the dynamic nature of the health care environment through benchmarking for best practices, networking, quality management, and other activities as needed
- Responsible for departmental personnel functions (ex: recruitment, onboarding and training, feedback and monitoring, corrective actions, etc.) in conjunction with supervisors and staff
- Write and conduct annual and interim performance appraisal reviews for the professional and any applicable nonprofessional staff direct reports
- Act as a liaison to facilitate communication and collaboration between all care partners (ex: physicians, hospitalists, nurse, community care managers, post-acute care facilities, and other community resources etc.)
- Responsible for mentoring and leading a high-performance team of "systems thinkers" who incorporate leadership principles and vision in performing the functions of case management
- Demonstrate initiative in identifying and pursuing opportunities for self-improvement and enhancement of professional competency and serves as a resource to the care management/case management team for self-improvement and enhancement of professional competency
- Use data to drive decisions, plan, and implement performance improvement strategies for case management.
Qualifications:
- Nursing (RN, LVN) degree preferred
- 5+ years demonstrating proven track record of strategic planning in managed care environment
- 5+ years of experience with UM (Outpatient or Inpatient)
- Strong leadership and communication skills
- Experience managing projects, including developing project plans, identifying and solving blockers, and reporting on status
- Strong data analysis skills
- Genuine interest in transforming the healthcare industry
Who We Are:
Astrana Health (NASDAQ: ASTH) is a physician-centric, technology-powered healthcare management company. We are building and operating a novel, integrated, value-based healthcare delivery platform to empower our physicians to provide the highest quality of end-to-end care for their patients in a cost-effective manner. Our mission is to combine our clinical experience, best-in-class delivery network, and technological expertise to improve patient outcomes, increase access to healthcare, and make the US healthcare system more efficient.
Our platform currently empowers over 10,000 physicians to provide care for over 1 million patients nationwide. Our rapid growth and unique position at the intersection of all major healthcare stakeholders (payer, provider, and patient) gives us an unparalleled opportunity to combine clinical and technological expertise to improve patient outcomes, increase access to quality healthcare, and reduce the waste in the US healthcare system.
Our Values:
- Put Patients First
- Empower Entrepreneurial Provider and Care Teams
- Operate with Integrity & Excellence
- Be Innovative
- Work As One Team
Environmental Job Requirements and Working Conditions:
- Our organization follows a hybrid work structure where the expectation is to work both in office and at home on a weekly basis. The office is located at 1600 Corporate Center Drive, Monterey Park, CA 91754.
- The total compensation target pay range for this role is: $80,000 - $110,000. The salary range represents our national target range for this role.
Astrana Health is proud to be an Equal Employment Opportunity and Affirmative Action employer. We do not discriminate based upon race, religion, color, national origin, gender (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender identity, gender expression, age, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics. All employment is decided on the basis of qualifications, merit, and business need. If you require assistance in applying for open positions due to a disability, please email us at humanresourcesdept@astranahealth.com to request an accommodation.
Additional Information:
The job description does not constitute an employment agreement between the employer and employee and is subject to change by the employer as the needs of the employer and requirements of the job change.