Manager, Case Management

Title: Manager, Case Management

Location: Long Beach

Department: Care Coordination

Status: Full-time

Pay Range*: $126,484.80 -  $189,716.80 /annually

MemorialCare is a nonprofit integrated health system that includes four leading hospitals, award-winning medical groups – consisting of over 200 sites of care, and more than 2,000 physicians throughout Orange and Los Angeles Counties. We are committed to increasing access to patient-centric, affordable, and high-quality healthcare; your personal contributions are integral to MemorialCare's recognition as a market leader and innovator in value-based and other care models.

Across our family of medical centers, we support each one of our bright, talented employees in reaching the highest levels of professional development, contribution, collaboration, and accountability. Whatever your role and whatever expertise you bring, we are dedicated to helping you achieve your full potential in an environment of respect, innovation, and teamwork.

Position Summary

Oversees and manages the case management department operations to ensure optimal efficiency and effectiveness. Reviews performance data and reporting to monitor and measure productivity. Monitors performance and provides mentorship and leadership to the team. Recognizes trends in barriers to care coordination and strategizes and executes remediation plans. Monitors and disseminates regulatory changes impacting the revenue cycle. 

Provides overall (24/7) management of the department. Responsibilities include planning, organizing, staffing, and directing and controlling care coordination activities. Provides oversight and broad direction to the department which includes care coordination, utilization review, and discharge planning. Works closely with the medical staff and leadership team to identify patient care needs. Ensures delivery of quality patient care in compliance with all regulations, adherence to hospital policies and procedures, and overseeing customer service, patient satisfaction, and staff performance and competence. 

Essential Functions and Responsibilities of the Job

1. Hires and develops staff and ensures competence of clinical and non-clinical personnel.
2. Quality services through effective management, planning, and education.
3. Participates in the development and implementation of goals, objectives, policies and procedures for the assigned department.
4. Collaborates with leadership to manage the operational and capital budget for the department to meet financial goals.
5. Ensures cost-effective daily operations and allocation of resources.
6. Maintains effective staffing plans and achieves staff productivity goals.
7. Monitors the appropriate unit metrics to assure high levels of patient satisfaction and that core measures and regulatory measures are being met.
8. Supports the strategic plan and the goals and direction of the performance improvement plan.
9. Works closely with nursing and medical staff leadership to ensure effective and efficient operations of the department.
10. Responds to and resolves difficult and sensitive patient care issues and customer inquiries and/or complaints.
11. Implements best practices in accordance with the hospital policies.
12. Participates in department specific performance improvement projects.
13. Performs care coordination, utilization review and/or discharge planning functions as needed.
14. Supports the Director and oversees the Director’s responsibilities on an interim basis.
15. Participates in activities to maintain magnet status.
16. Performs other duties as assigned.

*Placement in the pay range is based on multiple factors including, but not limited to, relevant years of experience and qualifications. In addition to base pay, there may be additional compensation available for this role, including but not limited to, shift differentials, extra shift incentives, and bonus opportunities. Health and wellness is our passion at MemorialCare—that includes taking good care of employees and their dependents. We offer high quality health insurance plan options, so you can select the best choice for your family. And there’s more...Check out our MemorialCare Benefits for more information about our Benefits and Rewards.

Minimum Requirements

Qualifications/Work Experience:

• Bachelor of Science in Nursing (BSN) required.
• Master of Science in Nursing (MSN) or master’s degree in healthcare-related field preferred.
• Management experience preferred.
• Registered Nurse (RN) in the state of California required.
• Basic Life Support (BLS) required.

Education/Licensure/Certification:

• Minimum 5 years’ experience in care management and utilization management preferred.
• Minimum 3 years’ experience leadership experience preferred.