CWR Case Manager - HS

This position has responsibility for ensuring quality care and appropriate services are provided to KP members experiencing continuing care services and hospital care across the program. In addition, this position, in partnership with several leaders across the regions is responsible to develop and implement the vision for care across the continuum and to create systematic opportunities for KP to continue to develop and lead as a community health system.

This position is accountable to ensure that KP scans the environment for successful practices, develops and tests care delivery practices, and implements future care delivery models that will position KP to lead into the future This position deploys measurement systems, operational processes, goals and investments to effectively improve the performance of the organization.  Effectively collaborates with the other national colleagues; Regional Presidents and area leaders, the PMGs, Program Office staff, and labor partners to improve the quality of care and service that we provide to our members and our communities.

This position is responsible to establish strategic direction and a system view to support the regions- provision of the continuum of care services: Home Health, Hospice, Palliative Care, Rehab Services, Dialysis/ESRD, EPRP, Population Management, SNF, Medical Transportation/Ambulance Services, Outside Medical Services and Referrals, DME, and Utilization Management. This position will provide national oversight and monitoring of the planning and implementation of continuum and community capacity management and strategic resource planning.

• Provide executive level leadership, strategic direction and recommendations over areas of accountability
• Identify and implement actions in areas of accountability to improve quality, service, financial performance and contractual compliance
• Supports the structure and processes to develop, implement and assure success of all areas related to the Continuum of Care. 
• Directs other activities as assigned that improve care to our members and the communities we serve
• Ensuring that Kaiser Permanente (KP) is strategically positioned to maintain ongoing regulatory compliance across the continuum of care, including NCQA accreditation, Medicare 5 Star compliance, DPH and CMS care delivery compliance
• Develops and monitors the payroll, non -payroll, and capital budgets and expenditures for assigned areas
• Identifying future demand by levels of care; including community resource capacity.
• Utilization Management: Support and guide the development and implementation of UM plans and agreements with KP hospitals and Core contracted/partner hospitals and Non-Core hospitals.
• Champions and implements care delivery innovations to achieve organizational goals. 
• Explores critical issues related to the Continuum of Care and Care for specific populations; such as complex needs patients; creating innovative care delivery models to address those needs.
• In partnership with key constituents, develops and implements the future vision for care across the continuum and as a progressive community health partner.