Health Plan Nurse Program Director

Job Description:

Health Plan Nurse Program Director

Description

The Position

Why Join Contra Costa County Health Services?
Contra Costa Health is offering an excellent opportunity for a Health Plan Nurse Program Director over the Case Management Unit, within the Contra Costa Health Plan (CCHP) division.

The Health Plan Nurse Program Director develops and supervises the day-to-day clinical programs, policies, and services of the Case Management Unit. In this role, you will provide clinical direction and supervision to licensed personnel that provide patient care coordination. You will oversee program planning and development, quality assurance, and improvement activities that support the enhancement of healthcare and long-term support services to health plan members.

Contra Costa Health Plan (CCHP) has been serving county residents with their health needs for over 40 years and was the first Federally qualified, State-licensed, County-sponsored Health Maintenance Organization (HMO) in the United States. Also, Contra Costa Health Plan (CCHP) became the first County-sponsored health plan in California to offer Medi-Cal Managed Care coverage.

We are looking for someone who is:

• A leader. You will be responsible for managing a high-volume workload and making decisions with minimal oversight.
• Action-oriented and results-focused. You must take initiative and ensure tasks are completed in a timely and efficient manner.
• A strong communicator. You will communicate with various entities daily, including internal staff, Providers, other County divisions, and community stakeholders, so clear and concise communication is important.
• Respectful and values diversity. You must see the benefit of having different backgrounds and views in the workplace and leverage those differences in group processes and decision-making.
• Resolute. At times you will have to be firm with your position to ensure the department is following the applicable laws and regulations.

What you will typically be responsible for:

• Overseeing and directing a team of nurse and social worker case managers
• Coaching and supporting staff
• Ensuring compliance with healthcare regulations and standards
• Developing and implementing case management programs and policies
• Coordinating with stakeholders to ensure social needs are addressed in care planning to improve health outcomes
• Initiating and coordinating department activities and trainings
• Providing clinical direction to licensed personnel
• Providing oversight of clinical assessments and health education activities
• Monitoring and evaluating the effectiveness of case management programs
• Implementing quality improvement initiatives
• Ensuring adherence to best practices and evidence-based care
• Managing resources for the case management unit
• Preparing reports and documentation for regulatory compliance
• Collaborating with internal and external partners and stakeholders to achieve organizational goals

A few reasons why you might love this job:

• You will have a supportive team with shared goals that are aligned with the organization’s commitment to serving the community.
• There is a true commitment to equity and dissolving disparities in the community.
• You will make an impact on staff success in their jobs.
• We offer generous benefits and a great retirement package!

A few challenges you might face in this job:

• You must know how to apply County policies, as well as State and Federal laws to execute decisions.
• You must have patience while waiting for processes to move forward.
• You may need to reprioritize assignments based on the ongoing needs of the organization.

Competencies Required:

• Critical Thinking: Analytically and logically evaluating information, propositions, and claims
• Legal & Regulatory Navigation: Understanding, interpreting, and ensuring compliance with laws and regulations
• Displaying Ownership and Accountability: Holding self and others accountable for measurable high-quality, timely, and cost-effective results
• Leadership: Guiding and encouraging others to accomplish a common goal
• Visionary Leadership: Taking a long-term view and building a shared vision with others; acting as a catalyst for organizational change
• Business Process Analysis: Defining, assessing, and improving operational processes and workflow
• Strategic Thinking & Perspective: Evaluating immediate actions in context of achieving long range objective
• Thinking & Acting Systematically: Formulating objectives and priorities, and implementing plans consistent with the long-term interests of the organization in a global environment

To read the complete job description, please click here . The eligible list established from this recruitment may be used to fill future openings for up to 6 months.

Minimum Qualifications

License Required: Candidates must possess and maintain throughout the duration of employment: a current, valid, and unrestricted Registered Nurse license issued by the California Board of Registered Nursing.

Applicants are required to attach a copy of their license and transcripts to their application.

Education: Possession of a Master's Degree in nursing, hospital or health care administration, or a closely related field, from an accredited college or university.

Experience: Five (5) years of full-time experience, or its equivalent, as a Registered Nurse, Utilization Review Nurse, Discharge Planner, Case Management Nurse, or a Telephone Triage Registered Nurse in a healthcare or managed care setting (e.g. Preferred Provider Organization, Managed Care Organization, or Health Maintenance Organization), at least one (1) year must have been at a supervisory level.

Substitution: Possession of a Bachelor's Degree in one of the fields noted above plus two (2) additional years of supervisory experience of the type noted above may be substituted for the Master's Degree. There is no substitution for the one (1) year of supervisory experience.

Possession of a Certified Case Manager (CCM) certification issued by the Commission for Case Manager Certification may be substituted for one (1) year of the required experience.

Selection Process

Application Filing and Evaluation: Applicants will be required to complete a supplemental questionnaire at the time of application. Applications will be evaluated to determine which candidates will move forward in the next phase of the recruitment process.

Training & Experience Evaluation: Candidates who clearly demonstrate that they possess the minimum qualifications will have their training and experience evaluated. The responses to the supplemental questions, at the time of filing, will be evaluated to determine each candidate's relevant education, training, and/or experience as presented on the application and supplemental questionnaire. (Weighted 100%)

For recruitment questions, please contact Health Services Personnel, Recruitment Team at Exams@cchealth.org . For any technical issues, please contact the Government Jobs’ applicant support team for assistance at +1 855-524-5627.

The Human Resources Department may change the examination steps noted above in accordance with the Personnel Management Regulations and accepted selection practices.

CONVICTION HISTORY

After you receive a conditional job offer, you will be fingerprinted, and your fingerprints will be sent to the California Department of Justice (DOJ) and the Federal Bureau of Investigation (FBI). The resulting report of your conviction history (if any) will be used to determine whether the nature of your conviction conflicts with the specific duties and responsibilities of the job for which you have received a conditional job offer. If a conflict exists, you will be asked to present any evidence of rehabilitation that may mitigate the conflict, except when federal or state regulations bar employment in specific circumstances. Having a conviction history does not automatically preclude you from a job with Contra Costa County. If you accept a conditional job offer, the Human Resources Department will contact you to schedule a fingerprinting appointment.

DISASTER SERVICE WORKER

All Contra Costa County employees are designated Disaster Service Workers through state and local law. Employment with the County requires the affirmation of a loyalty oath to this effect. Employees are required to complete all Disaster Service Worker-related training as assigned, and to return to work as ordered in the event of an emergency.

EQUAL EMPLOYMENT OPPORTUNITY

It is the policy of Contra Costa County to consider all applicants for employment without regard to race, color, religion, sex, national origin, ethnicity, age, disability, sexual orientation, gender, gender identity, gender expression, marital status, ancestry, medical condition, genetic information, military or veteran status, or other protected category under the law.

To find more information on Benefits offered by Contra Costa County, please go to https://www.contracosta.ca.gov/1343/Employee-Benefits

Closing Date/Time: 10/6/2024 11:59 PM Pacific

Salary:

$196,914.48 - $239,350.80 Annually