Manages the long term care activities which may include DME, SNF, eldercare for the Medical Center. Ensures compliance with Medicare, TJC, and other federal, state, and local requirements. Works with SNFs to ensure the quality of care and utilization, develops and maintains clinical practice standards, and ensures consistent implementation of benefits. Essential Responsibilities:Upholds Kaiser Permanentes Policies and Procedures, Principles of Responsibilities and applicable state, federal and l... more details
Description:
Job Summary:
Manages the long term care activities which may include DME, SNF, eldercare for the Medical Center. Ensures compliance with Medicare, TJC, and other federal, state, and local requirements. Works with SNFs to ensure the quality of care and utilization, develops and maintains clinical practice standards, and ensures consistent implementation of benefits.
Essential Responsibilities:
Upholds Kaiser Permanentes Policies and Procedures, Principles of Responsibilities and applicable state, federal and local laws.
Establishes, implements, and maintains patient care and service standards to meet members expectations.
Designs and evaluates processes and policies/procedures to improve systems and patient care results across the continuum of care.
Identifies issues and implements corrective action.
Ensures compliance in meeting all regulations and standards related to SNF, Medicare, TJC, Title 22, and other federal, state, and local requirements.
Collaborates with physicians, continuing care staff and outside providers/staff to improve integration and efficient management of long term care and programs for frail elderly.
Acts as liaison to patient, family, physicians; coordinates to assure high quality care ensuring smooth customer transitions through various care settings.
Ensures ongoing staff development.
Promotes quality and utilization standards to ensure cost effective and customer-focused delivery of care.
Interprets and explains the Kaiser Health plan program benefits to physicians, staff, members, caregivers, and outside services.
Assists in developing and monitoring budgets and resource allocations.
Monitors financial performance and identifies and implements strategies to reduce costs and improve quality of service/care.
Assume other activities and responsibilities from time to time as directed.
Basic Qualifications:
Experience
Minimum three (3) years of experience in SNF required.
Education
Bachelors degree required.
License, Certification, Registration
N/A
Additional Requirements:
Demonstrated management and leadership skills.
Knowledge of SNF, Medicare, TJC, and other federal, state, and local regulations.
Thorough knowledge of Kaiser Health Plan benefits.
Must be able to work in a Labor/Management Partnership environment.
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