Job Summary: The Assistant Vice President (AVP)-Care Coordination ensures the provision of: quality Case Management serving the inpatient and outpatient populations in a tertiary care facility with a level one trauma designation at multiple campuses of LLUMC including University Hospital (UH), East Campus (EC), Children's Hospital (CH), Surgical Hospital (SH) and LLUMC-Murrieta. The scope of work also includes quality clinical documentation improvement, quality and timely social services daily and 24/7 in the Emergency Department(s), transitional care management.  The AVP ensures departmental operations align with the goals, objectives, and key initiatives of the organization's strategic plan. Primary duties include the overall leadership, guidance, direction, and management of the organization's care coordination, social services, clinical documentation, utilization management and review functions and processes, transitional care management  and, collaboration with leadership, management, and staff on care model design, strategy, training and development, implementation, execution, and change management to assure both patient and financial outcomes are achieved. Performs other duties as needed.

Education and Experience: Bachelor's Degree in Nursing required. Master's in health related field or completion within one year required. Minimum of seven (7) years clinical bedside nursing required, ten (10) years preferred. Minimum three (3) years Case Manager experience required. Minimum five (5) years executive or director level leadership experience required. Minimum one year of lean-process re-engineering experience preferred. Minimum one year of management in multiple settings (acute, ambulatory, post-acute) preferred.

Knowledge and Skills: Experience with leading change; extensive knowledge of: reimbursement systems, federal, state, and payer-specific regulations, insurance regulations, Medicare/Medicaid guidelines, DRGs, complex disease processes, HIPAA, Patient Bill of Rights, medical necessity criteria. Broad knowledge of quality, patient safety, performance improvement, regulatory requirements, medical staff structure, peer review and legal aspects of care. Knowledge of quality, performance improvement and patient safety programs that are data-driven and utilize tools such as the rapid cycle testing, Lean, and Six Sigma. Able to read; write legibly; speak in English with professional quality; use computer, printer, and software programs necessary to the position (e.g., Word, Excel, Outlook, PowerPoint). Able to relate and communicate positively, effectively, and professionally with others; provide leadership; be assertive and consistent in enforcing policies; work calmly and respond courteously when under pressure; lead, supervise, teach, and collaborate; accept direction. Able to communicate effectively in English in person, in writing, and on the telephone; think critically; work independently; perform basic math and statistical functions; manage multiple assignments; compose written material; work well under pressure; problem solve; organize and prioritize workload; recall information with accuracy; pay close attention to detail. Able to distinguish colors as necessary; hear sufficiently for general conversation in person and on the telephone, and identify and distinguish various sounds associated with the workplace; see adequately to read computer screens, and written documents necessary to the position.

Licensures and Certifications: California Registered Nurse (RN) license required. Certified Professional in Healthcare Quality (CPHQ) preferred. LEAN or Six-Sigma preferred. Accredited Case Manager (ACM) or Certified Case Manager (CCM) certifications preferred. Project Management Professional (PMP) certification preferred.

 

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