Senior Director, Care Management

We are so glad you are interested in joining Sutter Health! Organization SHSO-Population Health Services-Valley Position Overview Play a critical role in Sutter Health's pursuit to transform healthcare by achieving the highest levels of quality, access, and affordability. Partner with leadership to achieve strategic initiatives such as Total Care Accountability, developing new product offerings and building partnerships related to healthcare reform opportunities. Oversee the planning and execution of care management activities to improve the coordination and transition of care. Develop systems and day-to-day operations to manage care across Sutter Health's continuum of healthcare services—acute, ambulatory, and palliative. Collaborate with to explore optimization opportunities, to identify business efficiencies and linkages, and to encourage cross-organization communication that enhances our competitive advantage and fosters a "One Sutter" face to our patients and their families. Lead and promote system-wide and OU-based best practices related to care management resources, continuity of care, disease management, and clinical outcomes of all case management and social services in both inpatient and outpatient settings. Deliver measurable results that reveal a higher level of quality care through expanded services and performance efficiencies while offering a cost-effective and value-add healthcare environment to our patients, caregivers and customers. POSITION LOCATION AND TRAVEL REQUIREMENTS: Provides Care Management leadership for Sutter Health’s Sacramento and Central Valley Divisions. Expected to reside within Sutter Health’s geographic footprint. This is a hybrid role, with a combination of remote work and on-site responsibilities. Travel is required to hospitals and other care delivery sites within the assigned divisions, as well as leadership meetings in the Bay Area and Central Valley regions. Job Description POSITION LOCATION AND TRAVEL REQUIREMENTS: Provides Care Management leadership for Sutter Health’s Sacramento and Central Valley Divisions.Expected to reside within Sutter Health’s geographic footprint.This is a hybrid role, with a combination of remote work and on-site responsibilities.Travel is required to hospitals and other care delivery sites within the assigned divisions, as well as leadership meetings in the Bay Area and Central Valley regions. Education Graduate of an accredited school of nursing Certification & Licensure RN-Registered Nurse of California Typical Experience 15 years of recent relevant experience. Preferred Experience Experience leading acute care management, utilization management, and social services operations within a multi-hospital health system.Demonstrated success in improving care progression, length of stay (LOS), patient flow, discharge efficiency, and transitions of care.Experience developing and implementing standardized workflows, system-wide best practices, and performance improvement initiatives across multiple facilities.Experience using data analytics, performance dashboards, and industry benchmarks to drive measurable improvements in clinical, operational, and financial outcomes.Demonstrated ability to collaborate with physician leaders, nursing, finance, managed care, and post-acute care partners to improve care coordination and optimize resource utilization.Knowledge of regulatory and accreditation requirements, utilization management practices, medical necessity criteria, and payer policies.Experience leading organizational change, developing high-performing teams, and driving accountability through measurable goals and performance management.Familiarity with Epic or other electronic health record systems and leveraging technology to improve care management workflows and operational effectiveness.Experience supporting value-based care initiatives, population health strategies, and partnerships across the continuum of care. Skills And Knowledge Expert level clinical knowledge in the area of care management principles as they relate to population health as typically acquired during 5-7 years of experience in senior level clinical managementComprehensive knowledge of Centers for Medicare and Medicaid Services (CMS) Conditions of Participation related to utilization review and discharge, including other federal and state regulations related to case management, social work, etc., across the care continuumGeneral knowledge of the health benefits business, clinical issues, market trends, medical management, medical care delivery systems, utilization management, quality management, contracting, benefits interpretation, provider relations and government rules and regulations impacting potential health care reimbursementWorking knowledge of state and federal regulations governing immunity for peer review confidentialityThorough knowledge of capitation and all of its implications to care delivery operations and management, including demonstrated success at improving the efficiency and effectiveness of large groups of physicians in significant capitated marketsIn-depth knowledge of: utilization review, case management, managed care, clinical effectiveness, clinical pathways, disease management, recovery audit contractor (RAC) responses and quality improvement (QI) initiativesWorking understanding of business planning including analysis, statistics, budgeting, feasibility studies and implementationUnderstanding of and experience with Lean or other process improvement philosophies and methodologies desired Established ability to define and implement an area-wide care management philosophy, goals and objectives, standards, and policies and procedures to achieve stated objectives while aligning with corporate strategies and goalsProven skills in leadership, facilitation, organization, prioritization, time management, team building, project management, negotiation and conflict identification and resolutionDemonstrated ability to work within and across all levels of a large health care organization, creating value and buy-in as a key driver of functional and cost-effective continuum of quality careWritten and verbal communication skills, including the ability to translate complex medical and business concepts into lay terms for diverse audiences including ceo's, medical group foundations, independent physician associations (ipas) and hospitalsSuperior analytical and problem solving skills, including the proven ability to deliver effective solutions and build consensus, while fostering collaborative working relationships with internal and external constituenciesExceptional attention to detail, with the proven ability for critical thinking in investigating and assessing complex issues, organizing and analyzing data, interpreting healthcare laws and regulations, andformulating constructive solutionsAdvanced level of computer competency in Microsoft Office Suite, as well as other relevant software for research and analysis These Principal Accountabilities, Requirements and Qualifications are not exhaustive, but are merely the most descriptive of the current job. Management reserves the right to revise the job description or require that other tasks be performed when the circumstances of the job change (for example, emergencies, staff changes, workload, or technical development). Job Shift Days Schedule Full Time Days Of The Week Monday - Friday Weekend Requirements None 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 $200,096.00 to $320,153.60 / annual salary The posted pay range is based on the position's primary work location. Candidates who reside and work outside of that location may be subject to a different pay range based on their work location. Candidate starting salaries consider 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.