The Manager of Digital Health Disease Management DHDM supervises Nurse Case Managers and support staff responsible for DHDM

Key Responsibilities:

• Oversees and coordinates day to day department operations, schedules staff to ensure adequate coverage, prioritizes workloads and assignments, covers team member duties as needed, resolves system issues, advises on work methods, functions as a resource and assists with escalations as needed to Director, Assistant Director and /or Medical Director as appropriate.
• Coordinates and/or leads case management teams with a variety of clinical and nonclinical staff to review specific routine, expedited and complex cases, optimize work flows and ensure appropriate scope of practice, and evaluate options for quality and efficiency along the DHDM process.
• Collects, analyzes, and reports data on processes and results, including referrals, productivity, escalations and outcomes
• Collaborates with management on operational and performance issues and the development of new processes and programs to improve systems and processes.
• Coaches and evaluates team members and participates in decision-making on hiring, salary actions, terminations, performance ratings, and other human resources matters.
• Pursues professional development and facilitates access to ongoing training, staff development, and educational opportunities for subordinate staff.
• Ensures adequate orientation, training, and mentoring of new staff. Keeps staff and patient care teams informed of changes and updates in processes, technology, regulations, and quality standards. Provides guidance and instructions on UM updates to processes, procedures and clinical guidelines/policies.
• Implements new methods, systems, and processes.
• Other duties as assigned.

• Bachelor's degree in nursing or related area, or equivalent combination of experience and training.
• Registered Nurse in the state of California.
• Five or more years of relevant experience.
• Experience must include 3-5 years of experience in a IPA/MSO or Health Plan/HMO. Experience with Commercial and Medicare lines of business.
• Strong hands-on experience with digital health disease management processes.
• Knowledge of DOFRs, MCG, Epic, HMO delegation (commercial and Medicare Advantage), compliance, risk, disease states.
• Experience and proven success in ability to effectively supervise a team and to manage the complex workflow and multiple priorities involved with care coordination and case management.
• Must have excellent skills to communicate and influence effectively with all levels of staff, physicians, patients and external constituents, both verbally and in writing.
• Solid technology skills with ease of use of all programs (such as EPC, mcg) and an ability to prioritize multiple tasks in a fast-paced environment.

• Previous DHDM experience

• Employment is subject to a criminal background check and pre-employment physical.
• Must be able to work various hours and locations based on business needs. Availability of weekend/holidays as needed
• Hybrid Schedule: The candidate selected will work in the office 1-2 days per week once you complete initial orientation.