Job Summary:
Oversees all business and clinical activities for diverse populations and multiple care settings including acute, post-acute, and sub-acute. Responsible for planning, implementing and managing quality/cost effective programs in order to optimize specific care settings, maximize the care continuum and leverage the integrated delivery system. In partnership with CPMG sets strategic direction for specific hospital-based services, post-acute care venues, and transitions. Leads work aligned with the organizations strategic goals and objectives. Oversees readmission work and quality care transitions both within the hospital and in the immediate post-acute transition for/with the hospital operations team. Accountable for creating a culture of compliance, ethics and integrity. Maintains knowledge of and assures departmental compliance with Kaiser Permanentes Principles of Responsibility and policies and procedures and applicable regulatory requirements and accreditation standards.
Essential Responsibilities:
This position, knows and complies with all Kaiser Permanente quality, safety, and emergency policies and procedures. Demonstrates quality and effectiveness in work habits and clinical practice in every interaction with patients, colleagues, providers, and leadership. Ensures patient safety in the preparation and provisioning of care related to but not limited to medications, procedures, infection prevention, fall prevention, including consistent use of two patient identifiers and procedural time outs. Reports safety hazards, accidents and incidents, and unsafe working conditions promptly.
Establishes strategic direction and objectives for hospital services through the design and implementation of programs that support care delivery, which ensure integrated, coordinated care between internal and external services for the entire hospitalized population.
Programmatically implements and evaluates management of selected high risk cases such as catastrophic, ventilator-dependent, complex and high risk cases affecting multiple internal or external systems. Develops, implements, and evaluates programs that address complex care needs of the acutely hospitalized population.
Provides direction for acute and post-acute care clinical teams regarding patient flow within the hospital and coordination of care through transitional services.
Collaborates with senior leadership to develop and implement strategic plans, operational goals and objectives, and business initiatives. Demonstrates strategic thinking in planning, implementing and evaluating programs tied to future growth of clinical operations. Develops and executes short- and long-term goals for the department consistent with organization goals and objectives.
Interfaces with internal and external providers, regional leadership councils, as well as other appropriate departments to provide expert consultation regarding hospital operations. Builds relationships with and provides hospital operations support to various departments and providers.
Monitors and manages cross facility projects to increase efficiency and improve processes. Engages in collaborative process improvement work that enhances hospital services. Involves physicians, Health Plan leadership and front-line hospital staff in the improvement and system-design activities.
Monitors department (s) performance along a set of key indicators, identifies problem/challenge areas, develops and implements changes to resolve issues.
Collaborates with the data and analytics teams to develop standards, quality assurance measures and utilization practices for diverse populations and care programs.
Plans and executes department and outside costs based budgeting.
Monitors and identifies trends in areas of managed care, hospital services and care delivery. Collaborates with senior and executive leadership to determine strategic approaches to program delivery and execution.
Coordinates program resources and issues with health plan staff and CPMG.
Supervises assigned staff. This includes interviewing, selecting, and training, motivating, evaluating, counseling, disciplining and terminating in compliance with EEO/AA goals and personnel policies of the organization. Responsible for the development of future leaders.
Other duties as assigned.
Basic Qualifications:
Experience
Minimum three (3) years management or supervisory experience in an acute care setting, healthcare organization or hospital related field.
Minimum eight (8) years experience in healthcare to include management of multiple services/programs, including program development, contract negotiation, monitoring quality assurance, skills in budgeting, forecasting, monitoring, controlling internal/external medical costs and staff supervision.
Education
Bachelors Degree in Nursing required.
License, Certification, Registration
Registered Nurse License (Colorado)
Additional Requirements:
Demonstrates ability to set priorities for multiple tasks and assignments to meet deadlines.
Knowledge of performance improvement principles, utilization management guidelines, clinical management protocols and EMR systems.
In-depth understanding of the rules and regulations including Medicare/Medicaid pertaining to care delivery and compliance in diverse care settings.
High level proficiency in MS Office Suite programs, including MS Access.
Experience in data management, analysis and analytics required. Effective interpersonal, communication and leadership coaching skills.
Compliance: In addition to defined technical requirements, accountable for consistently demonstrating service behaviors and principles defined by the Kaiser Permanente Service Quality Credo, the KP Mission as well as specific departmental/organizational initiatives. Also accountable for consistently demonstrating the knowledge, skills, abilities, and behaviors necessary to provide superior and culturally sensitive service to each other, to our members, and to purchasers, contracted providers and vendors.
Preferred Qualifications:
Certification in Case Management - CCM preferred.
Notes:
Travel requirement is local to hospital and post-acute facilities.