The UM Case Manager manages 24-hour departments providing patient care services. Ensures staff provide high quality, accessible, cost effective care, patient focused services to members across the continuum, which comply with local, state, and federal requirements. Develops and maintains clinical standards of care and practice; responsible for all resource budgeting, selection and development.

• Manages the operations of 24-hour departments that may be at multiple locations. Ensures assistants and staff provide the highest quality of care and are in compliance with the Nursing Practice Act, The Joint Commission, federal, state, and local requirements.
• Establishes, implements, and maintains patient care and service standards to meet members and internal client expectations.
• Oversees and develops standards of care and standards of practice, directs fiscal management, and quality improve systems and patient care results across the continuum of care.
• Develops and monitors budgets for the appropriate use of human and material resources. Monitors financial performance and identifies and implements strategies to reduce costs and improve quality of care/service.
• Determines the appropriate staff mix for department and develops processes to screen, interview, hire, train, and maintain the competency of all department staff. Ensures on going staff development.
• Manages and resolves human resource, employee and department safety, and risk management issues.
• Develops, implements, and monitors departmental policy and procedures which support the organization goals and business objectives and ensures they are met

• Minimum 5 yrs of nursing experience in both patient care and management/leadership roles required
• Minimum 4 yrs of previous supervisory experience required
• CA RN License
• Knowledge of Nurse Practice Act, The Joint Commission and other local state federal regulations.
• Demonstrated strong interpersonal communication skills
• Must be able to work in a Labor/Management Partnership environment.
• BSN or BA in healthcare related field preferred
• Master's degree preferred
• Care Coordination experience
• InterQual familiarity