West County Health Centers (WCHC) provides comprehensive and quality health care services to the communities of Western Sonoma County. We are a cohesive team of health care providers, support staff and volunteers dedicated to wellness, affordability, and excellence of care. Come and be a part of an amazing team!

JOB SUMMARY: The Complex Care Program Manager is a newly created role responsible for the operational and clinical oversight of the Complex Care Program service line. The Complex Care Nurse provides care coordination and clinical support for high-risk patients with complex medical, behavioral, and social needs. Working collaboratively with providers, behavioral health, psychiatry and community partners, the Complex Care Nurse supports improved health outcomes, reduced hospitalizations and emergency department utilization, and enhanced patient engagement. The role is responsible for developing individualized care plans, coordinating transitions of care, monitoring patient progress, and addressing barriers to care.

This role requires a field-based presence across all three health center sites in Guerneville, Occidental and Sebastopol. During the initial six months, remaining time will primarily focus on program development and administrative responsibilities. Following implementation of key program components, the role will transition to mostly field-based work, a small amount of direct patient panel management, and administrative responsibilities.

Direct Reports: Complex Care Nurses, HIV Complex Care Nurses, Healthcare for the Homeless Complex Care Nurse, Psych Complex Care Nurses, Complex Care per diem RNs

RESPONSIBILITIES:

• Operational Leadership - Manage day to day operations of complex care nurses, including staff scheduling, coordinating coverage, supervision, training and performance evaluations.
• Program Development – Develop and implement care management workflows, clinical pathways and evidence-based practices to support chronic disease management and transitions of care.
• Clinical Coordination – Ensure effective coordination among primary care, behavioral health, psychiatry and other clinical service lines.
• Performance Tracking – Utilize data, analytics and chart audits to measure program success, identify gaps and implement quality improvement initiatives. The Program Manager will do this in collaboration with the Director of Clinical Operations and Director of Quality.
• Compliance and Reporting – Ensure adherence to state and federal regulations, contractual requirements and organizational standards, including accurate and timely EHR documentation.
• Communication – Participate in the development of communication about the program on SharePoint and other communication channels for the awareness, engagement and adoption among providers and staff.
• Assist in emergencies or other clinical situations in which a nursing presence is indicated.
• Assist in the adoption and implementation of new technologies and activities that improve patient care and clinic efficiency.
• Bring agenda items to and participate in meetings as appropriate.
• Initiate variance reports for completion by the Clinic Manager or Site Medical Director.
• Must comply with all federal, state and local laws and regulations, and WCHC policies.

REQUIREMENTS:

• Current California RN license in good standing.
• Bachelor's degree in nursing required; master's preferred.
• Current CPR certification
• 3-5 years nurse leadership experience
• Minimum 3 years in care management, complex care or utilization management
• Experience managing high risk populations
• Experience in program development and/or personnel management
• Experience in FQHC or value-based care environments preferred
• Case Management Certification preferred
• Experience with interdisciplinary care models preferred

PHYSICAL REQUIREMENTS:

• Ability to bend and move arms with sufficient range of motion to complete patient related requirements, may need to assist patients onto exam table, must be able to lift 30 lbs., bend, kneel and twist as needed and hearing is required for patient assessments.
• Prolonged standing and occasional sitting required.
• Must be able to perform the essential duties with or without accommodations. Must possess basic office and equipment safety knowledge and practice.

We comply with applicable federal and state civil rights laws and do not discriminate based on race, ethnicity, color, national origin, citizenship, alienage, religion, creed, sex, sexual orientation, gender identity, gender expression, age, disability, or any other status protected by applicable laws.

Job Type: Full-time

Pay: From $55.00 per hour

Benefits:

• Dental insurance
• Employee assistance program
• Flexible spending account
• Health insurance
• Life insurance
• Paid time off
• Retirement plan
• Vision insurance

Education:

• Bachelor's (Preferred)

Experience:

• Case management: 3 years (Preferred)
• Nursing: 3 years (Preferred)
• Nurse leadership: 3 years (Preferred)

License/Certification:

• California RN License (Preferred)

Ability to Commute:

• Sebastopol, CA 95472 (Required)

Work Location: In person