Manager, Clinical & Case Management-Quality
Location: Modesto California
Description: SutterHealth is in need of Manager, Clinical & Case Management-Quality right now, this position will be placed in California. Further informations about this position opportunity kindly see the descriptions. Sutter Gould Medical Foundation is a not-for-profit health care organization dedicated to improving the health and well-being of people in the communities it serves. With 17 care centers in Modesto, Stockton and five other communities in the Central Valley, a full range of medical care is available at convenient locations. Physician services are provided by Gould Medical Group, Inc., serving Central Valley residents for more than 50 years.
Accountable for planning, direction, oversight, and evaluation of Clinical Quality and outreach s! uch as flu clinics, the Pay for Performance program and Rx Ren! ewal program. Responsible for IMQ Accreditation that occurs every 3 years, health plan audits, and for management of the Quality Department staff and programs. Responsible for coordinating appropriate peer review as it relates to patient complaints and clinical risks. Keeps the Director of Quality and the GMG Senior Medical Director of Quality (MDQ) appraised of issues and activities across the Group/Foundation related to functions reporting to this position. This position requires travel to meetings and training throughout the SHCVR as well as SH meetings held in locations outside of the SHCVR.
Sutter Gould Medical Foundation (SGMF)is a non-profit, multi-specialty health care organization affiliated with Sutter Health. Based in Modesto, SGMF provides quality medical care, health education and research activities in a five-county area. SGMF's medical staff includes family practitioners, internists and pediatricians, as well as a range of specialist physicians. Serv! ices include imaging, nuclear medicine, a health library, health education programs, occupational medicine, diabetes education, nutrition counseling, infertility counseling, and weight management.
Bachelor of Science degree in business or health care is required. Current RN license in the State of California. Five (5) years previous experience in Clinical Quality or Clinical Operations. Management experience in an ambulatory care setting preferred. An equivalent combination of experience and education (8 years) may be substituted. Experience in complaint resolution and working knowledge of the Lean processes. Must have knowledge of National and State Quality Metrics and qualifying organizations including NCQA, IMQ, IHA, Hedis, and Pay for Performance. Understands the quality and safety audit process of our contracted plans. Understands medical management principles and practices, financial processes, medical operations and planning (business and strategic), and pub! lic relations. Must also be familiar with medical group practice and ma! ny services it provides. Skills must include:
Understanding and using computers and software programs to include work processing , spreadsheets and graphing functions
The ability to analyze and interpret data and prepare concise, accurate reports
Must have problem-solving skills as well as the ability to coordinate and communicate effectively with diverse others including, colleagues and physician providers
Must possess:
The ability to prioritize make decisions and set clear expectations for others and hold them accountable. The ability to teach and develop others.
Excellent verbal and written communication skills.
Ability to foster a collaborative relationship with others, including clinical and medical staff members
The ability to work independently and effectively under tight timeframes and shifting priorities
The ability to be flexible and maintain composure in difficult situations
Ability to foster collaborative and cooperative working relationships with physicians, Director, and staff
Ability to organize work and to achieve goals and objectives
Ability to research and prepare comprehensive reports
Leadership, team-building, and consensus-building skills. Willingness to travel for business purposes to various care centers, the Bay Area, Sacramento, and other destinations as required.
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If you were eligible to this position, please email us your resume, with salary requirements and a resume to SutterHealth.
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This position starts available on: Tue, 07 Jan 2014 22:00:14 GMT
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