Care Management Manager: Clinic Care Management

Primary Duties And Responsibilities

The Manager of Care Management is responsible for the daily oversight and management of inpatient and care management staff. This position must support, concurrent, retrospective inpatient review, discharge planning, transitional care and care management programs for Hoag MG and IPA assigned membership. They are responsible for helping to develop and implement any necessary P&P’s and workflow to ensure consistency, effectiveness and efficiency in the use of all resources required to accomplish all department goals and objectives. They will identify any opportunities for and implement any changes necessary to improve upon workflows and department performance that will ensure a high level of satisfaction with our customers and compliance with all Federal, State and Health Plan requirements. They will monitor the department performance against these requirements. They will be a resource to staff for addressing difficult issues that arise within the department. Interface with Medical Directors, hospitalists, physicians, other department leaders and vendors as needed.

Qualifications

Education and Experience

• Current RN license in the State of California
• BSN or Bachelor Degree in Health Care related field
• Minimum of 2 years of supervisory experience required in medical group or health plan setting
• Experience of at least two years with Inpatient Case Management and/or Outpatient Care Management
• Have an understanding of nationally recognized criteria Milliman Care Guidelines/Interqual/CMS, etc.
• Fulfills mandatory stroke education requirements per certification agency

License Required

Active unrestricted RN license in the State of California

Hoag Memorial Hospital Presbyterian is a nonprofit regional health care delivery network in Orange County, California, consisting of three acute-care hospitals with sixteen urgent care centers, eleven health centers and a network of more than1,800 physicians, 100 allied health members, 8,000 employees, and 2,000 volunteers. More than 30,000 inpatients and 550,000 outpatients choose Hoag each year.

For over 70 years, Hoag has delivered a level of personalized care that is unsurpassed among Orange County’s health care providers. Since 1952, Hoag has served the local communities and continues its mission to provide the highest quality health care services through the core strategies of quality and service, people, physician partnerships, strategic growth, financial stewardship, community benefit and philanthropy.

Hoag offers a comprehensive blend of health care services including six institutes providing specialized care in the areas of cancer, heart and vascular, neurosciences, women's health, orthopedics, and digestive health through our institutes.

Hoag was the highest ranked hospital in Orange County in the 2024-2025 U.S. News &World Report, the only Orange County hospital ranked in the top 10 for California. The organization was ranked the #5 hospital in the Los Angeles Metro Area and the #10 hospital in California.

To learn more about Hoag’s awards and accreditations, visit: https://www.hoag.org/about-hoag/awards-accreditations/.

Hoag is an Equal Opportunity Employer and prohibits discrimination and harassment of any kind. Hoag is committed to the principle of equal employment opportunity for all employees and providing employees with a work environment free of discrimination and harassment. Hoag hires a diverse group of people in a manner that allows them to reach their full potential in the pursuit of organizational objectives.