Responsible for the operations for Clinical Resource Management Department. Accountable for leading the operations of the Clinical Excellence initiatives of the health system, and for oversight of the Case Management, Social Services, Utilization Review and Clinical Documentation Improvement functions of the acute care hospitals across the district. Accountable for leading the operations of the Clinical Excellence initiatives of the health system, and for oversight of the Case Management, Social Services, Utilization Review and Clinical Documentation Improvement functions of the acute care hospitals across the district.Responsible for the operations for Clinical Resource Management Department. Accountable for leading the operations of the Clinical Excellence initiatives of the health system, and for oversight of the Case Management, Social Services, Utilization Review and Clinical Documentation Improvement functions of the acute care hospitals. Provides oversight to ensure efficient and effective use of resources; appropriate placement of inpatients and transfer of patients from Palomar Health; flow of patients through the continuum of care; support from Social Services for mandatory reporting; ongoing review and improvement of clinical documentation of patient care; and, assistance to patients requiring social services to return to the community. Develops and mentors a high performing team for all areas of responsibility. Ensures financial viability by managing both applicable revenue and expenses with attention to supply cost utilization and a high level of productivity in cost centers under direct control. Coordinates directly with Managed Care Organizations and Palomar Health managed care and contract staff to ensure efficient care and appropriate reimbursement is received. Develops and implements cost saving measures associated with length of stay and appropriate utilization review. Speak and read English at a level that is sufficient to satisfactorily perform the essential functions of the position. Knowledge of standard office equipment (i.e., calculator, fax, photocopier) and personal computer and computer software skills (i.e., MS Windows, Excel, Access, Word, Powerpoint, internet, e-mail). Windows computer skills including proficient use of keyboarding, use of mouse or keys for functions such as selecting items, use of drop down menus, scroll bars, opening folders, copying and similar operations required upon employment or within the 1st two weeks of employment to perform the essential functions of the job. Performs other duties as assigned. Follows Palomar Health rules, policies, procedures, applicable laws and standards. Carries out the mission, vision, and quality commitment of Palomar Health.

 

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