Case Management Manager RN

Annual Salary Range: $108,805.00 - $175,760.00 per year The FBCM Manager is responsible for overseeing the operational aspects of the FBCM team across all levels of facility-based care, including admissions at Torrance Memorial Medical Center (TMMC), out of area (OOA) acute hospitals, both medical and behavioral and skilled level of care (SNF), while maximizing efficiency across the FBCM team.

The Manager, FBCM collaborates with IPA leadership, Torrance Memorial Health System, including hospitalists, physicians, other providers and external partners to ensure that members receive the right care, at the right time, in the right place.

Supports the mission of Torrance Memorial IPA. Establishes, maintains, and achieves departmental goals that are aligned with IPA initiatives including but not limited to Integrated Care Management

The FBCM manager will improve hospital and SNF metrics such as Average Length of Stay (LOS), Total Bed Days, and Readmission Rates.

Effective usage of high-risk patient identification programs and readmission reduction programs will ensure your effectiveness in this crucial role

Provide overall leadership and management to the facility based clinical staff

Fosters development of skills in others through coaching, feedback and encouragement. Guides clinical practice and development of quality improvement initiatives at a unit specialty or system level.

Identify opportunities for innovation and change in process and workflow across the facility-based team

Development of power point presentations, word documents and reports as needed to educate the teams in support of the strategic clinical initiatives developed by TMIPA

Work collaboratively with the other members of the Integrated Care Management leadership team to ensure cross functional support, integration and accountability both during facility-based care and transitioning to ambulatory settings.

Identify and report to leadership, network and staffing needs or gaps that impact team's ability to successfully transition members to appropriate lower levels of care

Under the direction of departmental leadership, collaborate with other departments within the Torrance Memorial Health System, including the Care Coordination Center, Home Health, Inpatient Case Management, inpatient physicians (ED, Hospitalists, etc.) and network physicians to integrate care and achieve optimal clinical outcomes for members.

Assess staffing needs across the facility-based team to ensure adequate coverage for all locations and all coverage needs both weekdays, holidays and weekends as defined by TMIPA leadership

Monitors staff performance on an ongoing basis, and coaches, mentors team members

Establishes, maintains, and achieves departmental goals that are aligned with IPA initiatives including but not limited to Integrated Care Management

Knowledge, Skills & Experience Required:

• Prefer OON, ER and IP experience in Case Management
• Five (5) to seven (7) years' managed care experience in the health plan or delegated medical group environment.
• Minimum three (3) years' experience in California HMO Case management in managed care organization or delegated medical group environment.
• Minimum three (3) years' management level experience, including managing direct reports.
• Demonstrated ability to lead high-performing team.
• Thorough knowledge of facility-based case management
• Experience working in a managed care environment.
• Discharge planning and Case Management in the acute and post-acute settings
• Understands use of evidence-based criteria for concurrent review (MCG)
• Knowledge and experience in navigating health plan and community resources.
• Knowledge of health plan and regulatory guidelines
• Excellent verbal and written communication skills
• Basic computer skills, including working knowledge of the Microsoft Office Suite

Education:

• Bachelor's (Required)
• RN License CA (Required)

Experience:

• Management : 3 years (Required)
• Inpatient : 3 years (Required)

Work Location: In person #LI-CS1