Manager Integrated Case Mgmt-SCMG - Corporate / Remote - FT - Days

Hospital Case Management Program Director

Shift Start Time : 8 AM

Shift End Time : 5 PM

AWS Hours Requirement : 8 / 40 - 8 Hour Shift

Weekend Requirements : As Needed

On-Call Required : No

Hourly Pay Range (Minimum - Midpoint - Maximum) : $67.189 - $86.695 - $106.201

The stated pay scale reflects the range that Sharp reasonably expects to pay for this position. The actual pay rate and pay grade for this position will be dependent on a variety of factors, including an applicant's years of experience, unique skills and abilities, education, alignment with similar internal candidates, marketplace factors, other requirements for the position, and employer business practices.

What You Will Do

Under the direction of the Sharp Community Medical Group (SCMG) Director for Health Service and in collaboration with the Health Services leadership team, this position is accountable for the development and implementation of an effective Hospital Case Management program (HCM) and Ambulatory Case Management (ACM) program that encompasses a patient centered care management approach that includes referral management, prior authorization, Case Management and Disease Care Management and Pharmacy. Manages the operations of the Hospital Case Management program and Ambulatory Case Management (ACM) Department and is responsible for the execution and coordination of all ACM activities including Pharmacy. Helps to plan, develop, organize, monitor, communicate and recommend modifications to the HCM Program, ACM Program and Pharmacy Program including all HCM, ACM and Pharmacy policies and procedures. Coordinates interdepartmental projects to assure quality outcomes. Develops and implements operational policies and procedures that have a direct impact on the HCM and ACM programs in accordance with NCQA standards, legislative, and contracted health plan requirements. Provides direct supervision of the HCM and ACM staff and models effective leadership and mentoring skills. Promotes staff development using the concepts and tools supporting the Sharp Experience. Collaborates with Sharp Management team to facilitate internal and external committees and / or initiatives to address quality improvement as a representative of SCMG. Provides support to the VP for Clinical Operations and HS leadership team to ensure regulatory and legislative compliance for the division. Under the direction of the SCMG Director for Health Services, develops financial (budget) and operational strategy of HCM and ACM Departments.

Required Qualifications

• Bachelor's Degree in Nursing Or
• Bachelor's Degree in Healthcare Administration.
• California Registered Nurse (RN) - CA Board of Registered Nursing -REQUIRED

Preferred Qualifications

Other Qualification Requirements

Essential Functions

Knowledge, Skills, and Abilities

Sharp HealthCare is an equal opportunity / affirmative action employer. All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, gender, gender identity, sexual orientation, age, status as a protected veteran, among other things, or status as a qualified individual with disability or any other protected class.