Supervisor, Health Plan Clinical Operations, RN

EDUCATION: Bachelor's: BS in Nursing or evidence of enrollment in BSN program with completion within 24 months OR Master's: Master of Social Work for Social Work Candidates Only OR Master's: MS in Nursing, Case management OR Bachelor's in a related field CERTIFICATION & LICENSURE: RN-Registered Nurse of California TYPICAL EXPERIENCE: 5 years of recent relevant experience.

SKILLS AND KNOWLEDGE: Knowledge of ACMA, CMSA, and NASW Standards of Practice. Knowledge of available health care and community resources A broad knowledge base of health care delivery and case management within a managed care environment. Comprehensive knowledge of laws, regulations and professional standards affecting case management practice in an integrated delivery system: including but not limited to: CMS, Title 22, CHA Consent Manual, CDPH and TJC.

Verbal and written communication skills. Demonstrated ability to develop and manage complex projects. Working knowledge of InterQual criteria.

Working knowledge of MIDAS and experience with an E.H.R. Ability to promote teamwork and to effectively function in teams, both as a leader and as a team member. Ability to interact effectively with key internal and external constituents using collaboration, negotiation and analytical problem resolution skills.

Effective human relations and interpersonal skills necessary to lead the efforts of diverse health professionals to meet program objectives. Ability to work effectively in a fast-paced environment, directing services at multiple locations. Analytical and mathematical skills.

Demonstrated ability to implement continuous quality improvement processes and techniques, including benchmarking and outcomes measurements preferred. PC skills, word processing, spreadsheets and managed care software programs. Adheres to Sutter Health policies and procedures and supports Sutter Health philosophies and initiatives.

Participates as a member of the utilization Management Committee (UMC). Job Shift: Days Schedule: Full Time Days of the Week: Monday - Friday Weekend

Benefits: Yes Unions: No Position Status: Exempt Weekly Hours: 40 Employee Status: Regular Sutter Health is an equal opportunity employer EOE/M/F/Disability/Veterans. Pay Range is $198,556.80 to $277,971.20 / annual salary The compensation range may vary based on the geographic location where the position is filled. Total compensation considers multiple factors, including, but not limited to a candidate's experience, education, skills, licensure, certifications, departmental equity, training, and organizational needs.

Base pay is only one component of Sutter Health's comprehensive total rewards program. Eligible positions also include a comprehensive benefits package. Working at Sutter Health Sutter Health values and supports the unique talents and strengths that each employee brings to our organization.

As a result, you are empowered to apply your passion for healing in innovative ways to care for patients and their families.