To plan, direct & manage clinical service delivery for Geriatrics & Long Term Care in partnership with the Chief of Continuing Care Services; assuring affordable, quality care & service in accordance with regulatory, contractual & accreditation standards/requirements; as well as the organization's mission & goals. Works in close partnership with the department Administrator & Chief of Continuing Care Services in establishing goals, objectives & workplaces for Geriatrics & Long Term Care.
- Provides personnel management for employees within the Geriatric & Long Term Care Programs; assuring effective staff/management relationships, communication, problem solving, staff retention & delivery of services consistent w/ member needs, quality care, regulatory requirements & organization objectives. Assures consistent administration of SNF benefit throughout the Northwest Region.
- Manages & oversees budget & operations performance improvement for Geriatrics & Long Term Care including monitoring & improving key quality & utilization management performance measures
- Works in partnership w/ the Geriatrics & Long Term Care Team, Chief & CCS Administrator & nursing facility administration to plan & develop programs, maintain & improve quality, maximize utilization management & regulatory compliance within Geriatrics & long term care assuring cost effective, quality care consistent w/ benchmarked clinical & organizational best practice. Provides oversight of quality & utilization management of contract SNF vendors.
- Assures the integration of quality clinical services & for Geriatric & Long Term Care patients & continuity of care across the care continuum through coordination of services w/ inpatient, outpatient, long term care & contract vendors/ providers. Assures maximum effective use of the Long Term Care setting to lower the costs of health care services consistent w/ quality patient care & clinical outcomes. Assures contract SNFs are adequately prepared to meet changing needs of Kaiser Permanente. Negotiates service levels & plans for care delivery for patients at SNFs.
- Manages member complaints & appeals, as well as staff grievances. Identifies & implements process improvements to prevent complaints & appeals whenever possible. Complies w/ Medicare & NCQA standards to adjudicate member benefits in partnership w/ department chief or his/her designee.
- Participates as an active member of the department management team in business planning, goal setting, performance improvement & evaluation, contract negotiation, budget & policy/procedure development. Substitutes for the department administrator upon request.
Oregon Association for Home Care
- 4 years ago - save job
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