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Dignity Health is an Equal Opportunity/ Affirmative Action employer committed to a diverse and inclusive workforce. All qualified applicants will be considered for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, marital status, parental status, ancestry, veteran status, genetic information, or any other characteristic protected by law. For more information about your EEO rights as an applicant, please click here.

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The Assistant Case Management provides support for the Clinical Services Department, including Outpatient Case Managers, Social Services team, and Health Education, specifically through the coordination of services within the DHMSO Clinical Programs and DHMSO Case Management program.   - Serves as an intake coordinator for referrals into disease management program(s), coordinating requests for services, monitoring members, and reporting findings. The Assistant Case Management is responsible for gathering clinical information from outside sources such as PCPs, specialists and other providers, hospital logs, Cerner, PCM, hospital case managers, and outpatient UM staff. - Maintain accurate records of referrals, appointments, evaluation and management process for the Clinic and Case Management program. Processes referral requests according to company policy - Functions as a resource for access into Cerner for Comprehensive Care and Case Management teams. - Confirms medications currently taken by member during each call. - May communicate obtained information to PCP, Home Visit Program MD or DHMSO Clinical Programs MD as directed. - Knowledge and understanding of IPAs, PPOs, and HMOs with regard to benefits, policies and procedures, documentation requirements and medical terminology. 
Job ID
2020-120138
Department
Care Coordination
Facility
Dignity Health Management Services Organization
Shift
Day
Employment Type
Full Time
Location
CA-Bakersfield
Provides support for the Clinical Services Department, including Outpatient Case Managers,  Social Services team, and Health Education, specifically through the coordination of services within the DHMSO Clinical Programs and DHMSO Case Management program.  Serves as intake coordinator for referrals into disease management program(s), coordinating requests for services, monitoring members, and reporting findings.  Facilitates communication between providers, DHMSO staff, hospital physicians, patients and their families with regard to coordination of services.   - Responsible for meeting all of the DHMSO Job Standards described below. - Contacts members who are identified as appropriate for medical management program(s). Explains process for telephonic management to members and obtains member consent to participate. Communicates via phone with members participating in the program(s). Contacts program participants at regular intervals to evaluate health status according to program protocol.  Reports variances to nursing staff assigned to the patient.  Confirms medications currently taken by member during each call.  May communicate obtained information to PCP, Home Visit Program MD or DHMSO Clinical Programs MD as directed. - Documents all contacts pertaining to assigned members in PCM. Utilizes e-mail communication to insure that all appropriate staff are kept informed of relevant issues.  Functions as a resource for access into Cerner for Comprehensive Care and Case Management teams.   Maintains accurate records of referrals, appointments, evaluation and management process for the Clinic and Case Management program. - Processes referral requests according to company policy. Responsible for insuring all authorizations are received by the appropriate parties. Responsible for faxing clinical information, orders and authorizations generated by the Clinic and Case Management program to providers.  May also assist with appointments as directed. - Responsible for gathering clinical information from outside sources such as PCPs, specialists and other providers, hospital logs, Cerner, PCM, hospital case managers, and outpatient UM staff. Forwards information to staff for the purpose of evaluation for initiation of management as well as ongoing management by the Case Management program. - Answers telephone inquiries professionally regarding issues that pertain to referrals and care (e.g., referral status, procedures on how to request authorizations, etc.). May assist with other clerical duties, including data entry, chart preparation, report generation and appointment scheduling, ordering supplies for the departments, general support for Case Management,  Social Services and Health Education.  - Verifies member eligibility, demographic information, and benefits as follows: - health plan eligibility or certificate number - effective date of coverage - cancellation date if member is dis-enrolled - patient address and phone number – ensures information is up-to-date - health plan and benefit options - ensures authorization is issued to appropriate member for appropriate benefit - verifies benefits per company policy for appropriate services - Verifies member’s Primary Care Physician and the Physician Specialist provider number to ensure that authorization is requested and issued to appropriate network provider. - Determines the appropriate financial responsibility assignment when processing authorizations and that information is entered into the system correctly, by utilizing the financial responsibility matrix and the shared risk matrix correctly.   JOB KNOWLEDGE, SKILLS & ABILITIES - Knowledge and understanding of IPAs, PPOs, and HMOs with regard to benefits, policies and procedures, documentation requirements and medical terminology. - Must have strong oral and written communication skills as well as organizational and project management skills. - Computer experience required with familiarity with QNXT, MS Windows (Word and Excel), and Cerner applications preferred.
Job ID
2020-113447
Department
Case Management
Facility
Dignity Health Management Services Organization
Shift
Day
Employment Type
Full Time
Location
CA-Bakersfield
What You’ll be Responsible For in this Role – Your Contribution & Career JourneyThe IT Business Analyst I’s (BAs) serve as the internal consultants between the business and Information Services. They assist in providing analysis and evaluation of business data, processes, and define report and data requirements.  As the internal consultants, BA I’s begin to develop relationships with key stakeholders to understand the business needs and bridge the gap with Information Services identifying opportunities to improve, develop, maintain and continuously monitor business performance.What We’re Looking For - Determines business requirements, reviews system capabilities, analyzes product performance, determines product requirements, troubleshoots problems, and trains end users. - Works with department directors, managers and end users to assess software application needs, provides input and recommendations to IT Management. - Begins to learn to serve as SME in the business - Develop and leverage relationships with peers, supervisors and management - Prepares routine project descriptions and needs assessments - Participates in the development of performance indicators for project-based initiatives and works to ensure effectiveness of performance indicators through monitoring and controlling - Assists in process of performing Data Analysis - Identify trends and explore root causes - Ensure positive data integrity and accuracy - Use data to develop creative and practical solutions to business problems - Present findings with developed written and visual summaries - Support the Data Governance Program as necessary - Responsible for following policies and procedures set by the Data Governance Program - Collaborate with the Data Governance team to document and update procedures - Assist in improving processes used by the business and Information Services - Conduct workflows, process diagrams and gap analysis to identify opportunities for process improvement - Assess scope and impact on business needs - Develop business cases for process improvements with cost, service, and benefit dimensions of proposed projects - Assist in the development of project plans - Use the appropriate project planning tools - Perform other duties as assigned
Job ID
2020-104718
Department
Information Technology
Facility
Dignity Health Management Services Organization
Shift
Day
Employment Type
Full Time
Location
CA-Bakersfield
What You’ll be Responsible For in this Role – Your Contribution & Career Journey The Business Intelligence Developer develops reports and data warehouses to monitor Dignity Health Management Services Organization’s key performance indicators and meet regulatory reporting requirements by providing the necessary data to business stakeholders. This role is responsible for creating and maintaining computer-based analytics solutions to support the company’s financial, clinical, and operational projects. What We’re Looking For Advanced understanding of theoretical and practical aspects of data information systems: - Spreadsheet manipulation, management, and reporting - Database structure and design - Database querying, ETL, index management, and SQL performance tuning and monitoring - Installation, implementation, integration, training, and support for custom and third-party software solutions   Advanced knowledge of data governance, data management, data modeling, data cleansing, data extraction and transformation, data migration, data integration and data mapping.   Advanced knowledge of standard HIPAA EDI transaction sets and secure communications - Support and maintenance of custom and third-party business intelligence applications - Reviews business requirements - Reviews System capabilities - Analyzes product performance - Determines product requireemnts - Schedules software installation and upgrades - Troubleshoots problems - Trains end users - Works with department directors, managers and end users to assess software application needs - Provides input and recommendations to IT Management - Works Closely with Business Analytics and Project Management staff - Identify data requirements of both internal and external requestors - Develop solutions to ensure that those requirements are met - Performs data extracts from databases in response to internal requests for data and/or reports  
Job ID
2019-78998
Department
Information Technology
Facility
Dignity Health Management Services Organization
Shift
Day
Employment Type
Full Time
Location
CA-Bakersfield
Conducts medical reviews for necessity, level of care, and benefit reviews rendered in the outpatient setting to ensure the patient receives the highest level of care.  Coordinates with providers, provider staff, and hospital staff, patients and patient family members to establish an appropriate level of care.   JOB KNOWLEDGE, SKILLS & ABILITIES - Knowledge of nursing processes, care management, and continuity of care. - Familiarity with regulatory requirements for managed care, HMOs, and EPOs. - Ability to apply criteria to identify appropriate level of care on all admissions and clearly document any research conducted and rationale of decisions made.  Ability to identify care needs across the age continuum and according to principles of growth and development over the life span. - Ability to apply appropriate business rules, medical guidelines and/or health plan benefits to authorization decision making. - Proficiency with health plan criteria/benefits and regulatory requirements as they relate to patient management across the continuum of care. - Proficient with standardized criteria, Interqual/Milliman, MCG, Medicare, etc. - Knowledge of network and benefit limitations and ability to collaborate with stakeholders to find alternatives that meet patient needs and achieve positive outcomes. - Knowledge of disease management strategies. - Basic knowledge of CPT and ICD 9/ICD 10 codes. - Ability to interpret and communicate complex contract or benefit language. - Willingness to work as part of a team, working collaboratively with others to achieve goals, solve problems, and meet established organizational objectives and management of patients.     #MISSIONCRITICAL #DHLeader
Job ID
2020-115025
Department
Case Management
Facility
Dignity Health Management Services Organization
Shift
Day
Employment Type
Full Time
Location
CA-Bakersfield
Conducts medical reviews for necessity, level of care, and benefit reviews rendered in the inpatient and outpatient setting to ensure the patient receives the highest level of care.  Coordinates with providers, provider staff, and hospital staff, patients and patient family members to establish an appropriate level of care.   JOB KNOWLEDGE, SKILLS & ABILITIES - Knowledge of nursing processes, care management, and continuity of care. - Familiarity with regulatory requirements for managed care, HMOs, and EPOs. - Ability to apply criteria to identify appropriate level of care on all admissions and clearly document any research conducted and rationale of decisions made.  Ability to identify care needs across the age continuum and according to principles of growth and development over the life span. - Ability to apply appropriate business rules, medical guidelines and/or health plan benefits to authorization decision making. - Proficiency with health plan criteria/benefits and regulatory requirements as they relate to patient management across the continuum of care. - Proficient with standardized criteria, Interqual/Milliman, MCG, Medicare, etc. - Knowledge of network and benefit limitations and ability to collaborate with stakeholders to find alternatives that meet patient needs and achieve positive outcomes. - Knowledge of disease management strategies. - Basic knowledge of CPT and ICD 9/ICD 10 codes. - Ability to interpret and communicate complex contract or benefit language. - Willingness to work as part of a team, working collaboratively with others to achieve goals, solve problems, and meet established organizational objectives and management of patients.
Job ID
2020-113446
Department
Case Management
Facility
Dignity Health Management Services Organization
Shift
Day
Employment Type
Full Time
Location
CA-Bakersfield
- Responsible for meeting all of the DHMSO Job Standards described below. - Prepares, enters and maintains provider contract information in all appropriate information systems and hardcopy files, insuring that information is readily available for reference by DHMSO staff by all appropriate means, including hardcopy and electronic. - Negotiates provider contract language and contract rates. - Acts as a resource for internal departments as well as external organizations and customers on contract interpretation and contract modification. - Organizes and attends meetings as necessary, including responsibility for agenda, minutes and handouts. - Performs and completes general office work, including clerical tasks such as filing, composing correspondence, contracts, and other related documents. - Secures one case agreement with non-contracted providers as requested. - Insures that supplies and equipment necessary to complete work assignments are available for continuity of workflow and cost effectiveness. - Provides support to designated management staff as assigned. - Assists with special projects as assigned.   #MISSIONCRITICAL
Job ID
2020-117944
Department
Managed Care Contracting
Facility
Dignity Health Management Services Organization
Shift
Day
Employment Type
Full Time
Location
CA-Bakersfield
- Responsible for meeting all of the DHMSO Job Standards described below. - Prepares, enters and maintains provider contract information in all appropriate information systems and hardcopy files, insuring that information is readily available for reference by DHMSO staff by all appropriate means, including hardcopy and electronic. - Negotiates provider contract language and contract rates. - Acts as a resource for internal departments as well as external organizations and customers on contract interpretation and contract modification. - Organizes and attends meetings as necessary, including responsibility for agenda, minutes and handouts. - Performs and completes general office work, including clerical tasks such as filing, composing correspondence, contracts, and other related documents. - Secures one case agreement with non-contracted providers as requested. - Insures that supplies and equipment necessary to complete work assignments are available for continuity of workflow and cost effectiveness. - Provides support to designated management staff as assigned. - Assists with special projects as assigned.   #MISSIONCRITICAL
Job ID
2020-103285
Department
Managed Care Contracting
Facility
Dignity Health Management Services Organization
Shift
Day
Employment Type
Full Time
Location
CA-Bakersfield
  Position Summary   Provides desktop hardware support for the user community. Performs work that tends to be entry level technological and business function complexity. Responsible for desktop hardware support to the user community for functional area(s).  Expectations of this role are good phone skills, proficient with typing and using PCs, but not expected to troubleshoot end user issues. Identifying the issue, the appropriate group to resolve the issue, and documenting the issue will be the primary duty of this position.   Core Duties   Responsibilities include, but may not be limited to the following job duties. - Responds to incidents and utilizes knowledge management. Escalates issues to the appropriate group to resolve the issue. - Responds to customer requests via the Service Management application utilizing repeatable documented procedures. Interacts with the customers in a courteous and professional manner. - May handle facility logistics including hardware receiving and maintenance of equipment depot; enters appropriate data into the device asset management system and the knowledge management system. - Receives necessary information and or training to perform issue identification.  - Participates in on-call rotation and provides on-call support. - May perform operations functions, entry, backup tape changes or other responsibilities as necessary to ensure the successful day-to-day operations. - Maintains awareness of and adheres to Operational Level Agreements (OLAs). - Interacts daily with the user community as it relates to Incident Management and Request fulfillment.  - Maintains understanding and adherence to policies and procedures and may provide input to creation or modification of policies.  
Job ID
2020-103441
Department
Information Technology
Facility
Dignity Health Management Services Organization
Shift
Day
Employment Type
Full Time
Location
CA-Bakersfield
The End User Technician II provides desktop hardware support for the user community. Works on multiple functional systems that tend to be of moderate to high complexity. Responsible for desktop hardware support to the user community for functional area(s) and ensure reliability of the devices.  
Job ID
2020-113118
Department
Information Technology
Facility
Dignity Health Management Services Organization
Shift
Day
Employment Type
Full Time
Location
CA-Bakersfield
The End User Technician II provides desktop hardware support for the user community. Works on multiple functional systems that tend to be of moderate to high complexity. Responsible for desktop hardware support to the user community for functional area(s) and ensure reliability of the devices.  
Job ID
2020-106691
Department
Information Technology
Facility
Dignity Health Management Services Organization
Shift
Day
Employment Type
Full Time
Location
CA-Bakersfield
Job Summary   The incumbent is a front line member of the Human Resources team responsible for supporting the Human Resources Leadership team on the full range of operational Human Resources activities within the facility and/or service area. The incumbent performs a hands-on role in providing human resources expertise in employee and labor relations, coaching/development, compensation, conflict management, organizational development, training and other HR activities. The incumbent supports specific groups, functions and/or geographies, and embeds self within the business to work closely with management and employees. The incumbent is also instrumental in initiating and driving HR programs/initiatives. The incumbent will also assist with employee engagement activities, advising leaders on and ensuring compliance with HR policies, procedures and practices. The incumbent is responsible for ensuring the efficient implementation of a single Dignity Health Human Resources delivery model which aligns the facility HR structure, processes and systems with Service Area HR strategies. The incumbent serves as an HR operational leader for the facility, ensuring all HR functions and activities enable business success. The incumbent assists the HR leadership team in continually refining the role of Human Resources within the facility/service area to assist in achieving their operational and strategic goals. Along with all other HR Leadership the incumbent will align and partner with and fully utilize the resources of all the COE's embedded in the service area or at the corporate level to ensure that together they provide and develop unique insights and great depth of expertise in the area of focus in order to partner with leaders to develop values based strategic solutions     Performance Expectations   - Provide HR generalist and organizational support to those that request or that are assigned in a professional manner. - Partner with the embedded or corporate COE leadership to provide the appropriate direction, guidance and expertise for the full scope of HR functions and activities including employee and labor relations, compensation, organization design/change, performance management, recognition programs, workforce planning/headcount management, talent management, learning and development and manager engagement. - Partner closely with the HR leadership and management teams to organize and manage functions in a way that optimizes our people assets, guiding them to execute on our people strategies. - Partner with HR leadership to implement, communicate and drive HR strategies and initiatives. - Partner with the appropriate COE to provide management with information, data analysis, metrics and tools that give insight on people issues including retention and career development. - Work the HR leadership team to assist the leadership teams to understand business strategies, diagnose current organization performance, and develop/implement plans to build needed organization capabilities and support aggressive growth. - Be a key member of the HR leadership team helping to develop world class HR capabilities. - Continually evaluate, as a key contributor to the leadership teams, the effectiveness of policies, processes and services to achieve the appropriate business targets and drive the appropriate change. This includes flexibility to work within constantly changing priorities with enthusiasm. - Serves as an advocate for the employee, management and the facility and encourages problem resolution through the chain of command. Assists in diagnosing and determining the scope of organizational issues, leveraging the HR Service Delivery Model to deliver the most effective solutions to drive necessary cultural change. - Assist in ensuring department is in compliance with Federal and State laws and regulations pertaining to human resource issues which includes ensuring consistent, thorough processes are maintained. - Assist in advising management and ensure compliance with laws and regulations pertaining to human resources. Assist in delivering processes and programs that ensure readiness and compliance in a highly regulated healthcare environment. - Assists in providing direction and support to management with interpretation of policies and procedures and collective bargaining agreements. - Partners with COE's in providing education and advice on proper documentation and/or legal requirements for performance improvement and termination process. - Performs other related duties as assigned or requested in a professional manner.
Job ID
2020-120091
Department
Human Resources
Facility
Dignity Health Management Services Organization
Shift
Day
Employment Type
Full Time
Location
CA-Bakersfield
Conducts medical reviews for necessity, level of care, and benefit reviews rendered in the inpatient and outpatient setting to ensure the patient receives the highest level of care.  Coordinates with providers, provider staff, and hospital staff, patients and patient family members to establish an appropriate level of care.   JOB KNOWLEDGE, SKILLS & ABILITIES - Knowledge of nursing processes, care management, and continuity of care. - Familiarity with regulatory requirements for managed care, HMOs, and EPOs. - Ability to apply criteria to identify appropriate level of care on all admissions and clearly document any research conducted and rationale of decisions made.  Ability to identify care needs across the age continuum and according to principles of growth and development over the life span. - Ability to apply appropriate business rules, medical guidelines and/or health plan benefits to authorization decision making. - Proficiency with health plan criteria/benefits and regulatory requirements as they relate to patient management across the continuum of care. - Proficient with standardized criteria, Interqual/Milliman, MCG, Medicare, etc. - Knowledge of network and benefit limitations and ability to collaborate with stakeholders to find alternatives that meet patient needs and achieve positive outcomes. - Knowledge of disease management strategies. - Basic knowledge of CPT and ICD 9/ICD 10 codes. - Ability to interpret and communicate complex contract or benefit language. - Willingness to work as part of a team, working collaboratively with others to achieve goals, solve problems, and meet established organizational objectives and management of patients.
Job ID
2020-106019
Department
Utilization Review
Facility
Dignity Health Management Services Organization
Shift
Day
Employment Type
Full Time
Location
CA-Bakersfield
What You’ll be Responsible For in this Role – Your Contribution & Career Journey The Information Technology Compliance Analyst applies knowledge of industry-specific information security regulations and principles of information systems management and security to ensure compliance and achieve optimal information security.  The Information Technology Compliance Analyst will be called upon to coordinate all compliance related activities in support of the corporate HIPAA Security regulations and the IT department’s policies and procedures.  What We’re Looking For - Proactively identifies and escalates incidents as well as operational performance concerns. - Manage workload, prioritizing tasks and documenting time, and other duties as directed by management. - Assists in Continual Service Improvement efforts by identifying opportunities for process improvement - Pursue continuing education to grow and maintain knowledge of best practices, compliance requirements, threats and trends in information security, translating into operational action items, policies, procedures, standards and guidelines as part of the IT Security team - Act as a security advocate for IT operations team’s adherence to Dignity Health policies and industry best practices. - Participate in the collection and documentation of departmental knowledge artifacts, participant in the population of knowledge management and collaboration systems for the IT Security team. - Communicates technical information to team members. - Assists Management in identifying knowledge gaps and providing training to Analysts and Technicians in the IT Security organization as directed.  
Job ID
2019-90348
Department
Information Technology
Facility
Dignity Health Management Services Organization
Shift
Day
Employment Type
Full Time
Location
CA-Bakersfield
What You’ll be Responsible For in this Role – Your Contribution & Career Journey The System Administrator II provides evaluation and implementation services for new products, technologies and solutions to address corporate business requirements. Works beyond the routine utilizing specialized knowledge and analysis of multiple variables. Has a comprehensive understanding and skillsets for supported platforms/products and environments. Effort and activities are divided between maintenance and support of existing environments, and implementation tasks. Project assignments can be large in scope but are typically of medium complexity. What We’re Looking For: - Provide exceptional customer service to DHMSO end users, Business Stakeholders and other members of DHMSO IT. - Perform daily production support activities - Participate in team on-call rotations. - Perform patching and code deployments across all environments - Participate in projects associated to the enhancement, upgrade/patching, or implementation of new or existing software solutions. - Coordinate implementation and support efforts between ETS and other DHMSO IT teams. - Provide oversight and facilitation of the DHMSO IT change management process as it applies to the System Administration team. - Perform source code/versioning management function adhering to technical management guidelines. - Perform source code/versioning management function adhering to technical management guidelines. - Provide ownership of technical issues within the System Administration group. - Assist with strategic planning activities (capacity planning, process improvement, maintenance, upgrade and end-of-life planning, roadmap development). - Conduct performance tuning and troubleshooting. - Build new test and production environments on existing or new hardware as required. - Assist with the design and implementation of a comprehensive monitoring and alerting process across all ETS platforms. - Identify automation opportunities and implement scripted solutions. - Assist with the implementation of a comprehensive and ongoing release management and planning effort. - Utilize standard tools and methodology to develop system and support performance metrics - Perform technical mentoring and cross training with other team members. - Demonstrate a basic knowledge & expertise with DHMSO business processes and routines. ~LI-DH
Job ID
2020-94713
Department
Information Technology
Facility
Dignity Health Management Services Organization
Shift
Day
Employment Type
Full Time
Location
CA-Bakersfield
  The Project Manager leads internal teams/task forces on enterprise wide projects. Responsible for planning, executing and managing multiple and/or large projects according to pre-determined timelines and budgets; assigning the project teams; building project plans; reporting status to the client and internal teams; and ensuring quality control throughout the project life cycle.   - Ability to create a comprehensive project plan which includes outlines the scope and project requirements, acknowledges critical milestones, and identifies resources, systems, and individuals needed to successfully execute the plan. - Ability to communicate effectively with clients to identify needs, evaluate alternative business solutions, and make sound recommendations. - Ability to effectively facilitate team and client meetings in order to understand the full scope of the project, assign tasks appropriately and ensure the project is progressing according to the project plan. - Knowledge of tools and methodologies that will best support the plan at each stage through completion. - Ability to delegate tasks and projects to appropriate team members and follow up to ensure timely completion. - Ability to provide feedback to team members; uses effective coaching and instruction to ensure individuals are participating and engaging in the project plan.
Job ID
2020-113110
Department
Project Management Office
Facility
Dignity Health Management Services Organization
Shift
Day
Employment Type
Full Time
Location
CA-Bakersfield
  The Project Manager leads internal teams/task forces on enterprise wide projects. Responsible for planning, executing and managing multiple and/or large projects according to pre-determined timelines and budgets; assigning the project teams; building project plans; reporting status to the client and internal teams; and ensuring quality control throughout the project life cycle.   - Ability to create a comprehensive project plan which includes outlines the scope and project requirements, acknowledges critical milestones, and identifies resources, systems, and individuals needed to successfully execute the plan. - Ability to communicate effectively with clients to identify needs, evaluate alternative business solutions, and make sound recommendations. - Ability to effectively facilitate team and client meetings in order to understand the full scope of the project, assign tasks appropriately and ensure the project is progressing according to the project plan. - Knowledge of tools and methodologies that will best support the plan at each stage through completion. - Ability to delegate tasks and projects to appropriate team members and follow up to ensure timely completion. - Ability to provide feedback to team members; uses effective coaching and instruction to ensure individuals are participating and engaging in the project plan.
Job ID
2020-106026
Department
Project Management Office
Facility
Dignity Health Management Services Organization
Shift
Day
Employment Type
Full Time
Location
CA-Bakersfield
What You’ll be Responsible For in this Role – Your Contribution & Career Journey The Quality Management Coordinator will be a part of the Quality Management department.  The department works to measure and improve clinical quality functions across the enterprise.  This consists of monitoring and analyzing electronically submitted digital representations of clinical services, and auditing to assure accuracy in reporting. - Provides general clerical support, including photocopying, scheduling and assisting with department meetings, and various other administrative duties. - Organizes and keeps minutes of department meetings, and coordinates incoming and outgoing messages by phone, fax, and email. - Support review of clinical documentation; review records for completeness, accuracy, and compliance with regulations. - Review, interpret and code medical documentation. Work with department resources to validate diagnosis coding. - Actively participate in Quality Management activities and teams to improve documentation retrieval outcomes and compliance with database measures. - Enters essential information into database from reports and other sources as instructed. - Maintain a current understanding of coding standards and government regulations to ensure compliance. - Maintain updates relative to CMS-HCC Risk Adjustment payment methodologies.
Job ID
2020-106029
Department
Risk Management
Facility
Dignity Health Management Services Organization
Shift
Day
Employment Type
Full Time
Location
CA-Bakersfield
The Quality Management Nurse provides direct local service area support to the Clinical Integration (CI) program.  The QM Nurse reports to the SCQCN Executive Director and is an employee of Dignity Health Managed Services Organization.   The QM Nurse provides local support to the CI Program through continuous interaction and education with the participating physicians and mid-level providers, as well as hospital QM staff.   PRINCIPLE DUTIES AND RESPONSIBILITIES: - Serve as a key interface and liaison for the local participating physicians through collaboration with the Executive Director, physician practice liaison, and other key members of the SCQCN leadership team. - Responsible for physician education and training on processes and workflow related to clinical initiatives undertaken as a part of the CI Program, including CPTII and HCPCS coding, documenting quality data in paper and electronic charts, and reporting via the dashboard. This requires travel to provide on-site training in physician offices. - Working closely with Physician Practice Liaison to provide physician office staff education regarding support for physician in implementing clinical initiatives undertaken within the physician’s area of specialty. - Collaborate with Physician Practice Liaison by developing proficiency in understanding quality data extracts and reporting. - Collaborate with the Physician Practice Liaison in analysis, monitoring and interpretation of ambulatory clinical quality data, using dashboard reports. - Provide one-on-one education on use of dashboard reports and other communications as appropriate to identify potential improvements and assist physicians in understanding methods and processes required to achieve measurable results. - Collaborate with the Executive Director and SCQCN Chief Medical Officer (CMO)/Medical Director in preparing analyses, as well as monitoring, interpreting, and educating on results of clinical (ambulatory and hospital) quality, cost and utilization data. - Responsible for monitoring and evaluating physician compliance and performance with quality standards, as identified in weekly, monthly and quarterly reports and provide feedback to the Executive Director. - Perform patient chart review to reconcile quality reporting results with chart documentation, using a sampling methodology approved by the Board of Managers. - Provide Executive Director with support on performance improvement and development of remediation plans at the local service area level. - Support marketing and communications with materials relating to disease management programs. - Attend local quality management committee meetings, if requested by the Executive Director. - Assists the Executive Director with other duties as assigned.     #MISSIONCRITICAL
Job ID
2020-118073
Department
Quality Management
Facility
Dignity Health Management Services Organization
Shift
Day
Employment Type
Full Time
Location
CA-Bakersfield
Position Summary:   Evaluates, develops, and coordinates social care plans to meet the needs of patients and their families.  Provides crisis intervention and assists families in understanding the implications and complexities of a patient’s medical condition and on-going care needs.
Job ID
2020-113451
Department
Care Coordination
Facility
Dignity Health Management Services Organization
Shift
Day
Employment Type
Full Time
Location
CA-Bakersfield

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