Assistant Director of Case Management and Utilization Review - RUHS - Medical Center
Assistant Director of Case Management and Utilization Review - RUHS - Medical Center
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$ 120730 - 181909
1 Vacancy
Job Description
ABOUT THE POSITION
- The County of Riverside Riverside University Health SystemMedical Center is seeking an Assistant Director of Case Management and Utilization Review to join our UR Case Management Department located in Moreno Valley.
The most competitive candidates will possess acute care hospital Case Management experience along with behavioral health experience.
The department is looking for only option 1 (Case Manager) experience at this time.
OPTION I
Education: Graduation from an accredited college or university with an Associates degree in nursing. A Bachelors degree in nursing is preferred.
Experience: Three years of charge nurse or supervisory experience working as a registered nurse in an accredited acute care hospital. Professional experience in case management and utilization review in a hospital is preferred.
Schedule: 9/80 after 90 days (negotiable)
Meet the Team!
To find out more about Riverside University Health System please visit: EXAMPLES OF ESSENTIAL DUTIES
Assist in directing planning developing and evaluating the case management and utilization review activities related to safe timely efficient and effective discharge planning within all areas of RUHS.
Develop standards for case management and utilization review policies and procedures to guide medical and nursing staff regarding referrals medical necessity admission/discharge/ transfer process and other utilization management activities; develop performance improvement plans; monitor quality indicators for care coordination utilization review and discharge planning.
Collaborate with physicians and nursing managers to develop and implement case management/utilization review plans in compliance with federal and state laws and regulations and with accrediting agencies.
Ensure staff and processes are maintained for appropriateness of admissions and interinstitutional transfers with related fiscal approvals for reimbursement or applications for emergency MediCal; ensure access to social services support for patients and their families.
Assist in designing recommending and initiating costeffective approaches to discharge planning to reduce length of stay and to optimize quality outcomes that balance utilization management and fiscal reimbursement; develop and implement action plans to optimize hospital reimbursement in collaboration with related departments.
Administer general personnel management matters and actions; resolve problems involving grievances and discipline.
Supervise recruit select assign orient and evaluate performance of staff; assess staff competency especially in performing clinical procedures; assess developmental needs of staff and provide training opportunities; counsel staff on performance expectations and discrepancies.
May participate in RUHS committees and processes focused on decreasing hospital length of stay and increasing efficiency.
Assist in strategic planning for the organization and align departmental goals and objectives with the mission vision and values of the organization.
May participate in local and national organizations to represent RUHS.
Maintain daily work assignments and attendance records.
May assist in the preparation of budgets for assigned areas and integrate with organizational budgets.
Maintain records and present oral and written reports.
Investigate complaints regarding patient care and staff.MINIMUM QUALIFICATIONS
- OPTION I
Education: Graduation from an accredited college or university with an Associates degree in nursing. A Bachelors degree in nursing is preferred.
Experience: Three years of charge nurse or supervisory experience working as a registered nurse in an accredited acute care hospital. Professional experience in case management and utilization review in a hospital is preferred.
Knowledge of: Principles and practices of nursing and patient care services for case management discharge planning utilization review social work and quality improvement related to care coordination across the continuum of care in an acute healthcare organization; Joint Commission state and federal laws and regulations related to case management and reimbursements; InterQual clinical criteria system; principles and techniques of effective supervision management and administration.
Ability to: Clearly and effectively communicate verbally and in writing with staff and the public; plan organize direct coordinate and review the activities of operating room/perioperative nursing services; supervise instruct motivate monitor train and evaluate professional and nonprofessional employees; recommend improvements in nursing operations consistent with current nursing trends; establish and maintain systems of records and reports; establish and maintain cooperative relationships with staff and the public.
OPTION II
Education: Possession of a Masters of Social Work degree preferably with specialization in medical social work from a recognized school of social work.
Experience: Two years as a medical social worker in a hospital or healthcare clinic or agency.
Knowledge of: Principles of effective management; medical social casework principles and practices; psychological aspects of physical and emotional disturbances and mental deficiencies; characteristics of emotional and mental disorders including their effect on the individual in the community; mental health local community resources and community support systems; laws regulations and policies standards of Joint Commission federal and state regulatory agencies; techniques used in providing casework consultation to staff.
Ability to: Plan organize and direct the social services of a hospital or health system; interpret regulatory agency policies and guidelines; organize County and community resources and contract providers to service the community and achieve program goals; define problems and develop and implement solutions; establish and maintain effective working relationships with other agencies community organizations and other hospital or health system divisions; prepare clear and concise reports. SUPPLEMENTAL INFORMATION
For further information please contact Sarah Teegarden at .
APPLICATION INFORMATION
Veterans Preference
The County has a Veterans Preference Policy applicable to new hires. To qualify upload a copy of your (or your spouses) Member4 Form DD214 indicating dates of service and a copy of your spouses letter of disability (if applicable) with your application. For privacy reasons it is recommended that you remove your social security information from the document(s). A Human Resources Representative will review the materials and determine if you qualify for veterans Veterans Preference Policy C3 is available here: https://rivcocob/boardpoliciesReasonable Accommodations
The County of Riverside is committed to providing reasonable accommodation to applicants as required by the Americans with Disabilities Act (ADA) and Fair Employment and Housing Act (FEHA). Qualified individuals with disabilities who need a reasonable accommodation during the application or selection process should contact the recruiter for the position noted above. For additional information and/or to obtain the appropriate form for requesting a reasonable accommodation please visit the Disability Access Office web page located at: https://rchr/disabilityProof of Education
If using education to qualify or when requested by the recruiter upload a copy of any license(s) official/unofficial transcript(s) degrees and/or related employment documents to your NeoGov account at the time of application and before the closing date. Official or unofficial transcripts will be accepted.If your education was completed outside of the United States you will need to provide a copy of your Foreign Education Equivalency evaluation from a member of the National Association of Credential Evaluation Services NACES or Association of International Credential Evaluators Inc. AICE.
Equal Opportunity Employer
The County of Riverside is an Equal Opportunity Employer. It is the policy of the County of Riverside to provide equal employment opportunities for all qualified persons. All applicants will be considered without regard to race color religion sex national origin age disability sexual orientation gender gender identity gender expression marital status ancestry medical condition (cancer and genetic characteristics) genetic information or denial of medical and family care leave or any other nonjobrelated factors.PreEmployment
All employment offers are contingent upon successful completion of preemployment requirements including a criminal background investigation which involves fingerprinting. (A felony or misdemeanor conviction may disqualify the applicant from County employment). A preemployment physical examination and background check may be required.Probationary Period
As an Approved Local Merit System all County of Riverside employees except those serving At Will are subject to the probationary period provisions as specified in the applicable Memorandum of Understanding County Resolution or Salary Ordinance. Temporary and Per Diem employees serve at the pleasure of the agency/department head.General Information
Current County of Riverside and/or current employees of the hiring department may receive priority consideration. Qualified candidates may be considered for future County vacancies.Job postings may close without notice based on application volume. Submit your complete application by the recruitment close date; no late applications are accepted. Ensure all relevant experience/education is reflected on your application/resume as a failure to demonstrate position requirements may disqualify applicants. A description of job duties directly copied from the job classification or job posting will not be considered.
Please read and follow any special application instructions on this posting. Click the Apply link located on this page to submit your application. For additional instructions on the application process examinations Veterans preference preemployment accommodation or other employment questions please refer to our web site .
If you are experiencing technical problems you may contact the governmentjobs applicant support desk Monday through Friday 6 am to 5 pm Pacific Time at or tollfree.
Required Experience:
Director
Employment Type
Full-Time
