Manager, Care Management (RN/SW)

Organization:SHSO-Population Health Services-BayPosition Overview:Manages the overall operations of the department for Sutter Health entities in accordance with current federal and state regulations and guidelines. Has frequent contact with the Administrative Team, Nurse Executives and Directors, Risk Management & Ethics staff, Ancillary Services, Revenue Cycle and Finance Department leaders, Medical Directors, Medical Staff leaders, physicians, contracted providers, community resources post-acute agencies, patients and their families.Job Description :EDUCATIONEquivalent experience will be accepted in lieu of the required degree or diploma.Bachelor's: BS in Nursing or Health Administration or equivalent education/experienceOR Master's: MS in Nursing, Case management, or related field; or Masters of Social Work for Social Work Candidates Only or equivalent education/experienceCERTIFICATION & LICENSURERN-Registered Nurse of California Upon HireOR LCSW-Licensed Clinical Social Worker Upon HirePREFERRED EXPERIENCE AS TYPICALLY ACQUIRED IN:8 years experience leading innovative case management programs.8 years experience in utilization management and discharge planning.8 years leadership experience in acute case management8 years experience with clinical assessment for clients with complex medical, emotional and social needs.8 years experience in coordinating UM Committees/and or Clinical Review teams.8 years experience coaching, counseling and administering corrective action.SKILLS AND KNOWLEDGEKnowledge of ACMA, CMSA, and NASW Standards of Practice.Knowledge of available health care and community resourcesA broad knowledge base of health care delivery and case management within a managed care environment.Comprehensive knowledge of laws, regulations and professional standards affecting case management practice in an integrated delivery system: including but not limited to: CMS, Title 22, CHA Consent Manual, CDPH and TJC.Verbal and written communication skills.Group presentation design and facilitation skills.Demonstrated ability to develop and manage complex projects.Working knowledge of InterQual criteria.Working knowledge of MIDAS and experience with an E.H.R. (EPIC preferred)Ability to promote teamwork and to effectively function in teams, both as a leader and as a team member.Ability to interact effectively with key internal and external constituents using collaboration, negotiation and analytical problem resolution skills.Effective human relations and interpersonal skills necessary to lead the efforts of diverse health professionals to meet program objectives.Ability to work effectively in a fast paced environment, directing services at multiple locations.Analytical and mathematical skills.Demonstrated ability to implement continuous quality improvement processes and techniques, including benchmarking and outcomes measurements.PC skills, word processing, spreadsheets and managed care software programs.Adheres to Sutter health policies and procedures and supports Sutter health philosophies and initiatives. Participates as member of the utilizationManagement committee (UMC).Strong problem resolution abilities and customer relation skillsPay Range: $80.60-$128.90The salary range for this role may vary above or below the posted range as determined by location. This range has not been adjusted for any specific geographic differential applicable by area where the position may be filled. Compensation takes into account several factors including but not limited to a candidate’s experience, education, skills, licensure and certifications, department equity, training and organizational needs. Base pay is just one piece of the total rewards program offered by Sutter Health. Eligible roles also qualify for a comprehensive benefits package.Job Shift:DaysSchedule:Full TimeShift Hours:8Days of the Week:Friday, Monday, Thursday, Tuesday, WednesdayWeekend Requirements:NoneBenefits:YesUnions:NoPosition Status:ExemptWeekly Hours:40Employee Status:RegularNumber of Openings:1Sutter Health is an equal opportunity employer EOE/M/F/Disability/Veterans.All qualified applicants will receive consideration for employment without regard to race, color, creed, religion, marital status, sexual orientation, registered domestic partner status, sex, gender, gender identity or expression, ancestry, national origin (including possession of a driver's license issued to individuals who did not present proof of authorized presence in the U.S.), age, medical condition, physical or mental disability, military or protected veteran status, political affiliation, pregnancy or perceived pregnancy, childbirth, breastfeeding or related medical condition, genetic information or any other characteristic made unlawful by local, state, or federal law, ordinance or regulation. External hires must pass a background check/drug screening. Qualified applicants with arrest and/or conviction records will be considered for employment in a manner consistent with Federal, state, and local laws, including but not limited to the San Francisco Fair Chance Ordinance.