Northbay Healthcare Group Fairfield , CA 94533
Posted 2 weeks ago
At NorthBay Health this Director provides oversight for all aspects of Care Management and Population Health which includes: Utilization Management, Utilization Review, Inpatient, Outpatient and Complex Case Management, Discharge Planning, Denial Management, and Social Services for the NorthBay Healthcare Group. This director will collaborate with Quality and Operations leadership to support key Population Health quality measures.
The Director in collaboration establishes overall direction for the above listed areas and implements policies, processes and procedures in support of these programs. They provide direct supervision to personnel and they are responsible for program development, documentation compliance, and compliance with health plan requirements.
In collaboration with the leader in Quality they will support strategic direction; identifies key measures of success (e.g. length of stay and readmission rates), and implements key processes to maximize efficiency of resource utilization. They will assume overall responsibility for coordinating/managing patient centered care activities for patients within the context of these functions. They will ensure cost effective and quality patient outcomes through the supervision of clinical/professional staff, collaboration with medical staff, nursing, and support staff. They will operate from an expert knowledge base of UM and Case Management and ensures compliance with state/federal and other regulatory and accreditation body requirements.
This individual must be fiscally responsible, be able to take on new responsibilities as needed, be able to accept accountability, maintain confidentiality, and operate effectively under pressure, display confidence and integrity in all interactions, and maintain a sense of humor.
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Northbay Healthcare Group