SHIFT: No Weekends

SCHEDULE: Full-time

Do you have the career opportunities you want in your current role? We have an exciting opportunity for you to join the nation's largest provider of healthcare services as a Sr Manager of Accountable Care.

HCA Healthcare is a national leader in providing modern, culturally competent, patient-centered care and we are driven by a single goal: the care and improvement of human life.

We offer you an excellent total compensation package, including competitive salary, excellent benefit package and growth opportunities. We believe in our team and your ability to do excellent work with us. Your benefits include 401k, PTO medical, dental, flex spending, life, disability, tuition reimbursement, employee discount program, employee stock purchase program and student loan repayment. We would love to talk to you about this fantastic opportunity.

The HCA Physician Services Group (PSG) is the physician and practice management solution for the Hospital Corporation of America (HCA). We lead a collection of highly motivated healthcare professionals just like you and creative leaders who are committed to excellence in every patient interaction. Are you excited yet?

Pacific Partners Management Services (PPMSI) is a managed services organization formed in 1997 with administrative offices located in Foster City, CA. We provide services to IPAs in the Santa Clara and Monterey Bay areas. Our managed care and ACO services support approximately 1,000 independent physicians and include executive management, full financial services, utilization management, quality improvement, credentialing, contracting, claims processing and provider and member network services.

PPMSI is part of HCA Physician Services Group (PSG), the physician and practice management solution for the Hospital Corporation of America (HCA). PSG operates more than 750 practices, Urgent Care Facilities, and partners with HCA’s 165 hospitals to structure employed provider programs, professional service agreements, and joint ventures that offer the communities we serve high quality, cost effective care. We manage a collection of highly motivated and innovative leaders who are committed to excellence in every aspect of their career.

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What you will do in this role:

The Manager’s primary function is to develop and implementaccountable care programs which meet contractually identified targets forefficiency and quality. The programs will be designed to implementinterventions which will subsequently prevent unnecessary admissions,readmissions, and overutilization in a healthcare system, to meet the TripleAim of better care, better health, and lower costs. The Manager initiates andcoordinates a multi-disciplinary team approach to case management across thecare continuum to ensure timely and appropriate access to care. The Manager will effectively manage patientsat high risk for healthcare complications to help improve their quality oflife.

DUTIESINCLUDE BUT NOT LIMITED TO:

CLINICALPROGRAM MANAGEMENT

1. Work with payors and other identifiedorganizations to develop and implement accountable care and chronic diseasemanagement programs, in accordance with contractual requirements.

2. Track, improve and provide andexecutive level summaries regarding the coordination, utilization, quality andcost of patient care, and the patient experience.

3. Track, improve and report results foridentified efficiency measures including but not limited to readmits, ERVisits, ASU, Radiology, Lab, Surg/Med bed days, gaps in care, and genericprescribing.

4. Review utilization reports providedby the payors and provide executive level summaries to the medical managementteam.

5. Work with team members, bothinternally and externally, to provide accountable program results, enrollmentinformation and required data elements.

6. Participate in accountable caremanagement meetings, both internally and externally, as required.

7. Attend accountable care trainingsessions, as required.

8. Work with the PPMSI medicalmanagement team to develop tools and methods of identifying high risk patientsusing payor information as well as in-house analysis.

9. Work with the Medical Management teamto develop tools and methods of identifying high risk patients using payorinformation as well as in-house analysis.

10. Ensure targeted high risk chronicallyill patients are enrolled in care management programs according to programrequirements.

11. Coordinate efforts with the QualityManagement team to meet quality gate targets for identified patients, asrequired by the accountable care programs.

12. Assume responsibility for specialprojects as assigned by the Medical Director.

CAREMANAGEMENT

1. Initiate and coordinate amultidisciplinary team approach to case management which includes patients, payors, and providers, across thecare continuum.

2. Evaluate patients’ comprehensivemedical and social support and devise a comprehensive plan of care to supportpatients’ self-management of condition(s), arrange for services and ensurecontinuity of care at optimal levels.

3. Design care plans which ensureseamless continuity of care, minimize the potential for duplication ofservices, and reduce fragmentation and gaps in care.

4. Enhance and continuously improvecommunication and collaborative relationships with multi-disciplinaryhealthcare team members including payors and providers.

5. Act as a patients advocate protectingprivacy and confidentiality issues.

6. Provide patient education, monitorhealth needs, and coordinate community resources.

7. Prevent adverse patient events tominimize poor outcomes.

8. Maintain a comprehensive workingknowledge of community resources, payor requirements, and network servicesavailable to the target population.

9. Identifying opportunities for healthpromotion and illness preventions.

TRAININGAND EDUCATION

1. Train case mangers on all aspects ofthe accountable care programs they administer.

2. Develop materials and train providersand their staff on accountable care programs emphasizing communication,coordination, collaboration and accountability.

3. Liaise with the Quality Management andNetwork Management teams to develop program awareness.

SKILLS

1. Advocacy, communication, educationand counseling, and resource research skills.

2. Core philosophy or values consistentwith a family-center approach to care.

3. Culturally effective capabilitiesdemonstrating a sensitivity and responsiveness to varying cultural characteristics and beliefs.

Qualifications

What Qualifications you will need:

EDUCATION:

Current unrestricted California RN Licensure required

EXPERIENCE:

Minimum of 3 years of previous experience in a managed care organization or other comparable experience required

Certified Case Manager Preferred.

HCA Healthcare ranks on Fortune’s list of Most Admired Companies for three consecutive years and HCA ranks 63rd on the Fortune 500 list. In addition, Ethisphere named HCA as one of the World’s Most Ethical Companies. We want you to join our tradition of excellence. Intrigued? We’d love to hear from you.

If you find this opportunity compelling, we encourage you to apply. We promptly review all applications. If you are highly qualified, you will hear from one of our Practice Managers. We are actively interviewing so apply today.

We are an equal opportunity employer and value diversity at our company. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status.

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