Why Join Contra Costa County Health Services?Contra Costa Health is offering an excellent opportunity for a Health Plan Nurse Program Director over the Case Management Unit, within the Contra Costa Health Plan (CCHP) division.
The Health Plan Nurse Program Director develops and supervises the day-to-day clinical programs, policies, and services of the Case Management Unit. In this role, you will provide clinical direction and supervision to licensed personnel that provide patient care coordination. You will oversee program planning and development, quality assurance, and improvement activities that support the enhancement of healthcare and long-term support services to health plan members.
We are looking for someone who is:- A leader. You will be responsible for managing a high-volume workload and making decisions with minimal oversight.
- Action-oriented and results-focused. You must take initiative and ensure tasks are completed in a timely and efficient manner.
- A strong communicator. You will communicate with various entities daily, including internal staff, Providers, other County divisions, and community stakeholders, so clear and concise communication is important.
- Respectful and values diversity. You must see the benefit of having different backgrounds and views in the workplace and leverage those differences in group processes and decision-making.
- Resolute. At times you will have to be firm with your position to ensure the department is following the applicable laws and regulations.
What you will typically be responsible for:- Overseeing and directing a team of nurse and social worker case managers
- Coaching and supporting staff
- Ensuring compliance with healthcare regulations and standards
- Developing and implementing case management programs and policies
- Coordinating with stakeholders to ensure social needs are addressed in care planning to improve health outcomes
- Initiating and coordinating department activities and trainings
- Providing clinical direction to licensed personnel
- Providing oversight of clinical assessments and health education activities
- Monitoring and evaluating the effectiveness of case management programs
- Implementing quality improvement initiatives
- Ensuring adherence to best practices and evidence-based care
- Managing resources for the case management unit
- Preparing reports and documentation for regulatory compliance
- Collaborating with internal and external partners and stakeholders to achieve organizational goals
A few reasons why you might love this job:- You will have a supportive team with shared goals that are aligned with the organization’s commitment to serving the community.
- There is a true commitment to equity and dissolving disparities in the community.
- You will make an impact on staff success in their jobs.
- We offer generous benefits and a great retirement package!
A few challenges you might face in this job:- You must know how to apply County policies, as well as State and Federal laws to execute decisions.
- You must have patience while waiting for processes to move forward.
- You may need to reprioritize assignments based on the ongoing needs of the organization.
Competencies Required:- Critical Thinking: Analytically and logically evaluating information, propositions, and claims
- Legal & Regulatory Navigation: Understanding, interpreting, and ensuring compliance with laws and regulations
- Displaying Ownership and Accountability: Holding self and others accountable for measurable high-quality, timely, and cost-effective results
- Leadership: Guiding and encouraging others to accomplish a common goal
- Visionary Leadership: Taking a long-term view and building a shared vision with others; acting as a catalyst for organizational change
- Business Process Analysis: Defining, assessing, and improving operational processes and workflow
- Strategic Thinking & Perspective: Evaluating immediate actions in context of achieving long range objective
- Thinking & Acting Systematically: Formulating objectives and priorities, and implementing plans consistent with the long-term interests of the organization in a global environment
License Required: Candidates must possess and maintain throughout the duration of employment: a current, valid, and unrestricted Registered Nurse license issued by the California Board of Registered Nursing.
Education: Possession of a Master's Degree in nursing, hospital or health care administration, or a closely related field, from an accredited college or university.
Experience: Five (5) years of full-time experience, or its equivalent, as a Registered Nurse, Utilization Review Nurse, Discharge Planner, Case Management Nurse, or a Telephone Triage Registered Nurse in a healthcare or managed care setting (e.g. Preferred Provider Organization, Managed Care Organization, or Health Maintenance Organization), at least one (1) year must have been at a supervisory level.
Substitution: Possession of a Bachelor's Degree in one of the fields noted above plus two (2) additional years of supervisory experience of the type noted above may be substituted for the Master's Degree. There is no substitution for the one (1) year of supervisory experience.
Possession of a Certified Case Manager (CCM) certification issued by the Commission for Case Manager Certification may be substituted for one (1) year of the required experience.
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