Manager Care Management - Regional Medical Center

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Manager Care Management - Regional Medical Center

Salary

$222,283.36 - $283,701.60 Annually

Location

San Jose Metropolitan Area, CA

Job Type

Full-Time

Job Number

25-B5B-A

Department

Santa Clara Valley Health Care - Valley Medical Center

Opening Date

03/28/2025

Closing Date

4/14/2025 11:59 PM Pacific

Bargaining Unit

92

Description

Under direction to manage and coordinate the patient care services for care management, discharge planning and utilization review program as required under Federal and State regulations and Santa Clara Valley Medical Center's Utilization Management Plan.

The Power of WE:  Together, we can make a greater impact. Bringing better care and expanding healthcare services across the community.

Santa Clara Valley Healthcare (SCVH) is the second largest public health care system in California and includes three acute care hospitals, 14 clinics and 60+ specialty and sub-specialty services. Our mission is to provide high-quality, accessible healthcare and excellent service to everyone in Santa Clara County.  

Santa Clara Valley Medical Center - SCVMC is a full-service tertiary acute care teaching hospital with 699 licensed beds providing a wide range of specialized services, including Rehabilitation, Burn, Trauma, and NICU. SCVMC was ranked by U.S. News and World Report as #6 Rehabilitation Hospital in the nation and #1 in the West and designated as a 2024 High Performing hospital for Maternity Care, Heart Failure, Stroke, Hip Fracture, and Pneumonia.

O'Connor Hospital- O'Connor Hospital (OCH) is a 358 licensed bed acute care facility offering a full range of inpatient and outpatient medical, surgical and specialty programs to residents of Santa Clara County. It was founded in 1889 as one of the first hospitals in the county. OCH has grown significantly over the past five years in both its inpatient volume and its Emergency Department visits. Along with these volume increases other ancillary and clinical departments like imaging, lab, pharmacy, and respiratory have seen growth as well.

St. Louise Regional Hospital- Since 1989, St. Louise Regional Hospital (SLRH) has been caring for the residents in Santa Clara and San Benito Counties, offering a wide range of inpatient and outpatient medical specialties. SLRH has 93 beds, is a Designated Primary Stroke Center, and is the only acute care hospital in the area. Located in Gilroy, SLRH maintains a CALSTAR 2 emergency helicopter base on the premises. 

Learn more about Santa Clara Valley Healthcare: https://www.scvh.org/homeand follow us on: LinkedIn | www.linkedin.com/company/county-of-santa-clara/

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Typical Tasks

The following are the duties performed by employees in this classification. However, employees may perform other related duties at an equivalent level. Each individual in the classification does not necessarily perform all duties listed.

  • Plans, organizes, and schedules staff to ensure appropriate staffing and caseload distribution to achieve goals of the utilization management plan and safe and timely hospital discharges;

 

  • Coordinates care management services with Nurse Managers to facilitate admissions through expedited patient discharges and patient flow through all phases of hospital care;

 

  • Directs, evaluates, and develops systems and procedures for efficient and effective operations for discharge planning, care management and utilization management;

 

  • Implements defined quality improvement and utilization management programs including, but not limited, to ensuring data collection, analysis of data, evaluation of outcomes and report generation;

 

  • Supervises, orients, directs, evaluates, disciplines, and is responsible for the training of subordinate staff;

 

  • Assesses staff competency and identifies the educational needs of staff as well as the quality of care management services delivered related to expected length of stay standards;

 

  • Coordinates and ensures interdisciplinary care team meetings occur to facilitate discharge planning activities on every inpatient care unit;

 

  • Communicates with staff and reports findings related to compliance with standards for care planning, discharge planning, utilization review, and related standards and regulations;

 

  • Recommends and ensures implementation of corrective action plans for care management and utilization management to achieve planned quality improvements in patient care services;

 

  • Collaborates with physicians, nurses, and other clinical staff to identify opportunities to improve functions related to care management and evaluate the impact of improvement activities;

 

  • Attends bed management and nursing meetings as required;

 

  • Serves as an expert resource and advisor regarding expected length of stay for a targeted diagnosis related group;

 

  • Optimizes utilization of the online care management program;

 

  • Participates as a member of the Nurse Manager leadership team;

 

  • Represents the Care Management Division as assigned and as needed to provide expertise regarding care management and utilization management functions;

 

  • May be assigned as a Disaster Service Worker (DSW), as required*;

 

  • Performs other related duties, as required.

Employment Standards

Sufficient education, training, and experience to demonstrate the ability to perform the above tasks, plus the possession and direct application of the following knowledge and abilities:

 

Training and Experience Note: The required knowledge and abilities are attained through possession of a Bachelor's degree, preferably in Nursing 

or

 Possession of a Master's degree in Nursing Administration

AND

 Three (3) years of professional experience in utilization review and/or case management or nursing management in a hospital setting.   One (1) year of lead or supervisory experience is preferred.

 

Special Requirements

  • Possession of a license as a Registered Nurse issued by the California Board of Registered Nursing prior to appointment and maintenance of the license for the duration of employment in this classification.

 

  • Ability to travel to alternate locations in the course of work.  If driving, possession of a valid California driver’s license prior to appointment and the ability to qualify for and maintain a County driver authorization.

 

  • *As a condition of employment, pursuant to California Government Code Sections 3100-3109 and Local Ordinance, all County of Santa Clara employees are designated Disaster Service Workers (DSWs), including extra help.  A DSW is required to complete all assigned DSW-related training, and in the event of an emergency, return to work as ordered.

 

Knowledge of:

  • Hospital organization, operations for emergency and acute care;

 

  • Principles and practices of nursing and patient care services for care management, discharge planning, and utilization management in an acute health care setting;

 

  • Federal and state health care laws and regulations common to the operation of hospitals in California;

 

  • Financial processes of various private and public funding sources;

 

  • Regulations of intermediary agencies pertaining to hospital stay coverage (e.g. Medicare/Medi-Cal);

 

  • Principles and applications of a hospital information system(s) as it relates to care management and utilization review;

 

  • Principles and practices of supervision, staff development, organization, administration, fiscal and program management;

 

  • Criteria for level of care and current standards in medical and nursing practice;

 

  • Available alternative patient services and treatments;

 

  • English usage, style, grammar, punctuation, and spelling;

 

  • Common computer systems and applications.

 

Ability to:

  • Act as a resource to physicians, nurses, and care management staff;

 

  • Keep abreast of, understand, interpret, apply, and implement healthcare laws, rules, regulations, and procedures;

 

  • Evaluate data and statistics and prepare reports;

 

  • Select, train, supervise, develop, evaluate, discipline, and motivate staff;

 

  • Work effectively as a member of a management team in a large health care organization;

 

  • Establish and maintain effective working relationships with those contacted in the course of work, at all levels, including colleagues, the public, and representatives of other agencies;

 

  • Communicate effectively, both orally and in writing, with people of diverse backgrounds and cultures.

The County offers comprehensive first-class medical, dental, and vision benefits plans for County employees and their dependents, including plans with no deductibles, no co-pays, no co-insurance, and no prescription drug co-pays. Learn more here.

The County also offers generous paid time off with significant vacation, sick time, and 13 paid County holidays annually! Details are included in the Memorandum of Understanding/Agreement with the bargaining unit applicable to the job classification.

In addition to the amazing perks above, the County also offers the additional benefits below.

Retirement Benefits
The County offers robust retirement plans including a 457(b) Deferred Compensation Plan (similar to the private sector’s 401(k) plan) and the CalPERS pension plan. In addition to lifetime retirement income available through the CalPERS pension plan, the 457(b) Deferred Compensation plan provides a great way to save for retirement and supplement the defined benefit pension available to employees. These plans help our employees build a plan for their future and contribute to their family’s long-term financial well-being.

Health Flexible Spending Account
The Health Flexible Spending Account (HFSA) empowers employees to manage healthcare expenses efficiently with tax-free contributions (up to $3,200 for the 2024 calendar year). Secure tax-free solutions for your healthcare expenses and enjoy the flexibility to manage your healthcare finances effectively with the HFSA.

Dependent Care Assistance Program (DCAP)
The Dependent Care Assistance Program (DCAP) enables employees to utilize tax-free funds for dependent care services, facilitating a convenient and cost-effective approach for managing your dependent care expenses.  The County also offers the Employee Childcare Assistance Plan, an employer-funded DCAP, for employees with annual income under $120,000.

Life and AD&D
The County offers life and disability benefits including Life Insurance, Accidental Death and Dismemberment (AD&D) Insurance, Long-Term Disability insurance, California State Disability Insurance, and Integration with Leave. These benefits ensure financial security and income support when you and your family need it most.

Employee Assistance Program (EAP)
The County prioritizes employee mental health and well-being and offers a top-tier Employee Assistance Program (EAP) through Concern providing confidential counseling sessions covering stress, anxiety, relationships, grief, as well as financial/legal services, personal coaching, child and elder care referrals, and comprehensive crisis support.

Employee Wellness
The Employee Wellness Program offers free wellness programing, fitness classes and resources; including Elevate My Wellness an all-in-one platform designed to elevate your well-being journey.

Education Reimbursement
A generous Learning and Employee Development program is available, including Education Reimbursement for employees seeking additional training and professional development.

NOTE: Benefit and Retirement information may vary from bargaining unit to bargaining unit.  Due to changes in State Law, current pension provisions described in the union contracts are not automatically applied.  Specific pension benefits for new hires who start on or after January 1, 2013 may be different than indicated in the union contracts.

Click here to access all Memoranda of Understanding and most recent Summary of Changes.

01
Please answer the following questions. Completion of the following supplemental questions is REQUIRED and is an integral part of the evaluation process. Initially, it will be used to determine minimum qualifications. For those applicants meeting the employment standards, this information will be critical in the subsequent competitive assessment to identify those candidates to be invited to continue in the examination process. Your responses to the questions may also be reviewed and scored in a Competitive Rating evaluation process based on pre-determined rating criteria. Your answers should be as complete as possible, as no additional information will be accepted from applicants once the Competitive Rating evaluation has begun. A response of "see resume" or "see application" will deem your application incomplete.
Include a detailed description of your work experience in the following format for EACH employer referenced, in each answer:
a) Employer name(s)
b) Job title(s)
c) Start/end dates of employment
d) Total hours worked per week
e) Description of task(s) performed

Do you understand the requirement to provide complete answers in order to determine relevant experience for each area in question?
  • Yes
  • No
02
What is the highest level of education you have completed?
  • High School or GED equivalent
  • College (1 to 29 semester units / 1 to 44 quarter units)
  • College (30 to 59 semester units / 45 to 89 quarter units)
  • College (60 to 89 semester units / 90 to 134 quarter units)
  • College (90 to 119 semester units / 135 to 179 quarter units)
  • College (120 or more semester units / 180 or more quarter units)
  • Associate's Degree
  • Bachelor's Degree
  • Master's Degree
  • Doctoral Degree
  • None of the above
03
Do you possess a Registered Nurse license issued by the California Board of Registered Nursing?
  • Yes
  • No
04
How many years of professional experience in utilization review and/or case management or nursing management in a hospital setting do you possess?
  • None
  • One to less than two years.
  • Two to less than three years.
  • Three to less than four years.
  • Four to less than five years.
  • Five or more years.
05
How many years of lead or supervisory experience do you possess?
  • None
  • One to less than two years.
  • Two to less than three years.
  • Three to less than four years.
  • Four to less than five years.
  • Five or more years
06
How did you find out about this job?
  • Contacted by County Recruiter
  • Virtual Job Fair
  • In Person Job Fair
  • In-Person Networking Professional Event
  • Virtual Networking Event
  • Community Event
  • Glassdoor
  • Governmentjobs.com
  • Professional Association
  • Search Engine (Google, Bing, online search, etc.)
  • Hospital Website: SCVMC, O'Connor Hospital, St. Louise Regional Hospital Website
  • Contacted by a Recruitment Firm
  • Handshake
  • Student Career Center
  • County Text Message
  • County Career Newsletter
  • Other (Specify in the next question)
  • County Employee Referral
  • County of Santa Clara Career Website
  • County of Santa Clara Job Interests Email Notification
  • Facebook
  • Instagram
  • LinkedIn
  • Indeed

Required Question

Employer
County of Santa Clara
Address
70 W. Hedding Street
8th Floor, East Wing
San Jose, California, 95110
Phone
(408) 299-6816