Director of Care Management

  • Compensation: $125,000 - $170,000
  • Required Qualifications: Registered Nurse (California) RN / R.N.
  • City/State: San Fernando Valley, CA

We are currently seeking a talented, energetic and motivated Director of Case Management to lead their Outpatient Care Management team in the San Fernando Valley!

Here’s why you’ll love working for the Medical Group:

  • Growing fast than just about anyone out there: went from 500 employees to nearly 2,000 in 5 years!
  • Opportunity to make an incredible impact: currently touching 400k+ lives, many of whom are underserved, and looking for compassion and care.
  • Offering some of the best benefits out there: tuition reimbursement, 401k, free individual Medical coverage, tons of PTO, etc.
  • Family-like culture, where everyone gets the support they need: we’ve helped 20+ employees get hired here in the past year, and have gotten incredible feedback about their educators and managers.
  • This immediate opportunity will be responsible for the oversight, management and optimization of all quality improvement, utilization management and care management activities as it relates to pre-admission, ambulatory case management, medicare medi-cal, and outpatient care management.

Responsibilities include:

  • Leadership of 20-40 employees
  • Management of staff directly responsible for the day-to-day operations of the care management programs.
  • Contributing to the clinical, quality, financial and patient satisfaction outcomes of the region.
  • Working closely with all members of the Care Management team as well as members of Utilization Management, Contracting and the Office of the Medical Director to ensure compliance with all regulatory requirements.
  • Acts as a resource to other departments in regards to Case Management, Disease Management, and Chronic Care Management.
  • Collaborates with appropriate, Medical Directors, and other staff as well as other division peers
  • Program Development, Implementation and Evaluation
  • Conduct needs assessment including: development of methods for determining potential patient enrollment, medical literature review, analysis of pre-program utilization and return on investment
  • Development of Program to include establishment of policies and procedures, enrollment strategies, member and physician materials, and measurements of program outcome
  • Development of clinical practice guidelines
  • Evaluate staff educational needs and coordinate training

Qualified candidates:

  • Minimum 2 years of management experience in outpatient case management
  • Strong background in either Case Management, Care Management, Utilization Management, Utilization Review, for either a Hospital, Medical Center, Health Plan, or Medical Group is preferred
  • Registered Nurse / RN