1.         Oversees patient care services including the planning, development, implementation and evaluation/improvement of clinical care services/programs.

2.         Manages outpatient programs, services, operations in order to deliver quality nursing services and outpatient care which are integrated with business plans and meet or exceed cost, quality, clinical and utilization standards and performance measures.

3.         Achieves integrated services across the continuum of care and manages and ensures continuous improvement of all clinical practices, services, and operations by designing and implementing systems, processes and methods to evaluate and improve patient care.

4.         Plan, participates in development of, and deliver staff educational programs to enhance the staff clinical/management expertise.

5.         Participates as part of management team in formulating, implementing and evaluating business plans/strategies and new models/methods of service delivery for clinical care services.

6.         Ensures quality patient outcomes for key areas of responsibility (i.e.,Healthcare Effectiveness Data and Information Set (HEDIS), preventive care and ‘meaningful use’).

7.         Ensures patient care staff provides the highest quality of care in compliance with Nurse Practice Act, TJC, NCQA, federal, state and local requirements.

8.         Collaborates with physicians, nursing and other health care providers in establishing, implementing, and maintaining patient care and quality service standards to meet members' and internal clients' expectations.

9.         Conducts audits and oversees health plan and regulatory compliance.

10.       Acts as a patient advocate resolving patient care issues.

11.       Designs and evaluates processes to improve systems and patient care results across the continuum of care.

12.       Provide input to budgets and monitors financial performance and identifies and implements strategies to reduce costs and improve quality.

13.       Participates in development of, implements, and monitors departmental policies and procedures which support the organization's goals and business objectives and ensures they are met.

14.       Coordinates delivery of Patient Care Medical Home services.

15.       Participates in development of processes to screen, interview, hire, train, and maintain the competency of all department staff.

16.       Perform all other related duties as assigned.

1.  Bachelor’s degree in Nursing required. Masters degree in nursing, health services, business administration or management preferred.
2. Current valid license as a registered nurse through the California Board of Registered Nursing required.
3. Minimum of 4 years experience in clinical care management or other related clinical management experience also required.
4. Demonstrated interpersonal and communication skills; knowledge of clinical care practices, operations and local, state and federal regulatory standards.
5. Prior experience with an Electronic Health/Medical (EHR/EMR) system preferred.
6. Must maintain current CPR/First Aid Training.

Please apply here.