Search jobs > Renton, WA > Director case management

Director, Care Coordinator/Case Management

Kaiser Permanente
Renton, Washington
Full-time

Description : Job Summary :

Responsible for the overall design, care model, coordination, management, evaluation, and continuous quality improvement of the care coordination / case management and care transition programs for the KP Washington region.

Programs include but are not limited to : Emergency Patient Resources and Options (EPRO), Care Transitions, Referral Coordination, Urgent Care and Emergency Department Case Management, and Medical Transportation.

Essential Responsibilities :

  • Provides direction and expertise to KP WASHINGTON care coordination / case management, care transition programs, and related services.
  • Lead a department with frontline staff providing care coordination / case management to members across the region.
  • Provides oversight and integration of overall operations (Washington, human resources, and competency) for all programs.
  • Assists the VP of Care and Utilization Management in providing strategic leadership to ensure efficient utilization of resources and the delivery of quality, cost effective, efficient health care to meet established goals, objectives, policies, and regulatory requirements.
  • Monitors and assesses trends and best practices in care coordination, complex case management, care transitions, and makes recommendations to develop / adjust strategies, programs, and service delivery to meet changing business and market conditions.
  • Partners with continuum leaders to ensure seamless transition of members.
  • Partners with leaders across the enterprise-on-enterprise initiatives
  • Directs, staffs and organizes the care coordination / case management and care transition programs across the region. Continually evaluates and improves the quality of the care and services provided.
  • Designs, plans, and implements an effective, efficient, and quality model of care to provide for the needs of members, physicians, and personnel.
  • Establishes appropriate program goals and objectives and related metrics to measure the effectiveness of the program.
  • Develops, monitors, and controls payroll, non-payroll and capital budgets and expenditures for all programs.
  • Monitors operational and financial reports and implements improvement plans as required.
  • Ensures the development and implementation of care coordination / case management and care transition policies and procedures.
  • Ensures ongoing education and competence measurement of care coordination / case management and care transition personnel.
  • Makes hiring decisions, takes disciplinary action, and conducts performance assessments for assigned staff.
  • Participates in committees and / or projects.
  • Collaborates effectively with internal and external stakeholders to ensure the effectiveness and efficiency of the programs.
  • Performs other duties as assigned.

Basic Qualifications :

Experience

  • Minimum five (5) years of clinical experience required.
  • Minimum four (4) years of management experience in health plan / hospital / Case Management required.

Education

Bachelors degree in nursing or healthcare or business-related field.

License, Certification, Registration

Licensed Independent Clinical Social Worker (Washington) OR Registered Nurse License (Washington)

Additional Requirements :

  • Knowledge and expertise in case management scope of practice, technique and community resources.
  • Demonstrated knowledge of case management, discharge planning, transition of care, transfer coordination; NCQA,
  • Skilled collaborator and team builder.
  • Ability in planning, organizing, conflict resolution, negotiating and interpersonal skills.
  • Knowledge regarding compliance requirements by the various regulatory agencies and various legislative directives affecting health care management and reimbursement.
  • Excellent communication skills, good problem-solving skills, and decision-making skills; PC skills to include Microsoft word, excel, power point, and electronic medical record.
  • Strong customer service orientation required.
  • Must be able to work in a Labor / Management Partnership environment.

Preferred Qualifications :

  • Masters degree in nursing, healthcare or business-related field.
  • Case Management Certification.
  • 30+ days ago
Related jobs
Promoted
Coordinated Care
Auburn, Washington

Leads and directs the care management team and the care management of members to develop and assess high quality, cost-effective healthcare outcomes. Leads and enforces care management policies and procedures within the care management team to ensure compliance with regulatory requirements for feder...

Promoted
Optum
Seattle, Washington
Remote

Ensure appropriate management/resolution of local queries regarding patient case management either by responding directly or routing these inquiries to the appropriate SME. Optum Home & Community Care, part of the UnitedHealth Group family of businesses, is creating something new in health care. We ...

Promoted
Sea Mar Community Health Centers
Bellevue, Washington

The Case Manager is responsible for providing support to patients and families, and technical or caseload support to the care management team. Full-Time Case Manager position available for our Care Management Department in Bellevue, WA. The CM Case Manager’s function is to help patients a...

Promoted
Coordinated Care
Auburn, Washington

Leads and directs the care management team and the care management of members to develop and assess high quality, cost-effective healthcare outcomes. Leads and enforces care management policies and procedures within the care management team to ensure compliance with regulatory requirements for feder...

Promoted
Community Health Plan of Washington
Seattle, Washington

Knowledge of the various components of managed care operations and the linkages between them (quality improvement, disease management, population health management, care management, and claims operations). Have a minimum of ten (10) years utilization management or related managed care experience, wi...

Kaiser Permanente
Renton, Washington

Responsible for the overall design, care model, coordination, management, evaluation, and continuous quality improvement of the care coordination/case management and care transition programs for the KP Washington region. Programs include but are not limited to: Emergency Patient Resources and Option...

Promoted
Optum
Seattle, Washington
Remote

Ensure appropriate management/resolution of local queries regarding patient case management either by responding directly or routing these inquiries to the appropriate SME. Optum Home & Community Care, part of the UnitedHealth Group family of businesses, is creating something new in health care. We ...

Kindred Hospital Seattle - First Hill
Seattle, Washington

Under the supervision of the Director of Case Management (DCM) or designee, completes various duties to enhance the efficiency of the Case Management Department, as well as support the daily functions of the Case Managers. Assists the Case Management team by making necessary arrangement for post-dis...

UnitedHealth Group
Seattle, Washington
Remote

Ensure appropriate management/resolution of local queries regarding patient case management either by responding directly or routing these inquiries to the appropriate SME. Optum Home & Community Care, part of the UnitedHealth Group family of businesses, is creating something new in health care. We ...

Kindred Hospitals
Seattle, Washington

Under the supervision of the Director of Case Management (DCM) or designee, completes various duties to enhance the efficiency of the Case Management Department, as well as support the daily functions of the Case Managers. Assists the Case Management team by making necessary arrangement for post-dis...