California Healthcare News · California Healthcare News ... reimbursement will cover the cost of this population because: 1) ... SHPS net income declined due to

VOLUME 4, ISSUE 1 JANUARY 2012

cahcnews.com Articles, Interviews and Statistics for the Healthcare Executive

California Healthcare News®

Inside This Issue

California Health Plans Report Solid Profits Through September 30, 2011

1

Healthcare Administration:Infection Prevention Goals Build Culture of Safety at Adventist’s White Memorial Medical Center

6

Career Opportunities 8

Please see> Profits, P2

California Health Plans Report Solid Profits Through September 30, 2011However, Most Plans Show Lower Net Income than the Same Period in 2010

By David PeelPublisher and EditorCalifornia Healthcare News

California domestic health plans recently reported third quarter 2011 financial results and thirty of the largest thirty-five plans re-corded a profit. However, twenty-one of the plans reported lower net income than the same time period in 2010, suggesting premiums may rise more than usual in 2012.

We present two reports, attached as Tables 1 (page 4) and 2 (page

5), that show financial and per member per month figures for the largest thirty-five domestic health plans operating in California for the periods ending September 30, 2011 and September 30, 2010. When the financial figures are divided by member months (the combined total of month ending membership for each nine month period), a monthly average is obtained that is valuable when comparing financial and member-ship results. Unfortunately, given healthcare reform and the current volatility associated with state and federal health benefit programs, comparisons could be inconclu-sive and require additional analy-sis beyond the scope of this article.

All information in this report was obtained through publicly avail-able reports on the California De-partment of Managed Health Care (DMHC) web site. Information not required to be filed with the DMHC (self-insured and parts of California insured business from non-domestic carriers) is not in-cluded in this report nor is it refer-enced in this article.

Comments from Industry Rep-resentatives

We asked representatives of the plans to confirm the figures in the two tables and to give us insight into their financial results. Some plans chose not to reply to our re-quest while others replied with confirmation of the financial infor-mation but didn’t comment on their financial results. However, others provided valuable comments and these replies are sorted in descend-ing order by organization size.

-2-

Publisher and EditorDavid Peel

Managing DirectorElizabeth Peel

Contributing EditorNora Haile

AdvertisingJennifer Sharp

Contact InformationPhone: 425-577-1334Fax: 425-242-0452

E-mail: [email protected]: cahcnews.com

TO GET YOUR COPYIf you would like to be added to the distribution, go to our web site at www.cahcnews.com, click on the “subscribe” tab at the top of the page and enter all information requested. Be sure to let us know whether you want the hard copy or the web version. LETTERS TO THE EDITORIf you have questions or sug-gestions regarding the News and its contents, please reply to [email protected].



Kaiser Permanente Finance Com-munications Director, Bob Garcia, explained his organization’s reduc-tion in net income, “Due to market volatility and fluctuations, as well as the timing of our quarter close (September 30, 2011), we experi-enced a net loss in non operating income, which accounts for the net income decrease. We do not an-ticipate this issue next quarter.”

< Profits, from P1

Health Net of California repre-sentative Brad Kieffer told us, “Membership in Health Net's tai-lored network products grew by approximately 45.0% from Sep-tember 30, 2010 to September 30, 2011. These products accounted for 31.2% of the company’s West-ern Region commercial enrollment as of September 30, 2011 com-pared with 21.5% as of September 30, 2010. Tailored networks are networks of health care providers that are smaller and more cost-ef-fective than our full statewide net-work. Some health plans call these ‘narrow networks’.”

Kieffer continued, “Another factor is our Medicaid enrollment in Cal-ifornia at September 30, 2011 was 988,000 members, an increase of 92,000 members, or 10.3%, from September 30, 2010.”

Aetna of California’s Anjie Cop-lin, Director of Communications, explained her organization’s strong financial performance, “Our com-mercial underwriting performance continued to benefit from lower-than-projected utilization, our pricing discipline and our medical cost management strategies.”

Scan HealthPlan representative Ross Goldberg said, “Scan Health Plan’s membership decreases are the result of two contributing fac-tors: a Medicare requirement to discontinue some in-home servic-es that SCAN previously provided and decisions to terminate some medical groups in the SCAN net-work. The change in net income is a reflection of decreased member-ship.”

Central California Alliance for Health Chief Financial Officer,

Patti McFarland, said, “The reason our income declined is because we were accruing for the 10% Medi-Cal provider cuts that the state legislature passed effective 6/1/11. We recently received the actual rates associated with the cuts and are evaluating them. I expect that our net income will go up but it is premature to say by how much.”

Los Angeles County, Depart-ment of Health Services Chief Fi-nancial Officer, Office of Managed Care/Community Health Plan, Rogers Moody, told us, “Our net income decreased because of 1) Risk adjusted rates received in the Medi-Cal line of business, and 2) Capitation rate increases granted to our provider groups.”

Alameda Alliance for Health’s Amanda Flores-Witte, Senior Di-rector, Communications & Mar-keting, told us, “The Alameda Alliance for Health’s increase in member months and net income decrease is primarily due to the re-cent transition of Seniors & People with Disabilities (SPDs) into Me-di-Cal managed care. This popula-tion has a higher than average rate of utilization for medical care and pharmacy, and they require high touch customer service. Since the transition of SPDs into managed care, the Alliance has seen a 13% increase in call volume for the period of July-November 2011 in comparison to the prior six month period (January-June 2011). We have also seen an increase of 8.5% in the average duration of calls because of the complexity of the SPD population. In addition, the Alliance has had to do outreach and education to providers, phar-macists and others who were serv-ing this population in Medi-Cal

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Volume 4, Issue 1

cahcnews.com

fee-for-service.”

Flores-Witte continued, “At this point, we are unsure if the State reimbursement will cover the cost of this population because: 1) the transition of SPDs is still under-way, so we do not know if the higher than anticipated utilization is disproportionate to what we will experience when the entire mem-ber pool is enrolled, 2) as these members are introduced to better coordinated care, the medically necessary services may actually increase, and 3) the reduction in reimbursement as a result of the State budget will have an impact.”

Scripps Health Plan Services, Inc.’s Steve Bell, Director of Fi-nance, said, "Scripps Health Plan Services, Inc. (SHPS) had a slight decline in Medicare Advantage (HMO) enrollment from 2010 to 2011. During this same time SHPS net income declined due to reduced pricing for administrative services (MSO) fees."

Kern Health Systems Chief Fi-nancial Officer, Keith Quinlivan, described his organization’s mem-bership and net income growth by saying, “Kern Health Systems is a Medi-Cal plan. The high unem-ployment figures in Kern County and the mandatory enrollment of SPD members into managed care plans has enhanced both the rev-enue and enrollment of the plan.

San Francisco Health Plan’s Robert Menezes, Director of Com-munications, said, “San Francisco Health Plan’s increase in member months and the net income de-crease are predominantly attrib-uted to the recent State mandate of Seniors & People with Disabilities

(SPDs) into managed care. This population by nature has higher than average utilization rates for medical care and pharmacy ser-vices. In addition, more substan-tive operational devices such as customer service and case man-agement resources are required. Through September 2011 we’ve added approximately 4,600 SPDs to our member population, and by June 2012 we anticipate that up to 17,000 SPDs may join SFHP as a result of the mandate. The cost of care for Seniors & People with Disabilities is substantially higher, and in this early stage the State re-imbursement rates for this popu-lation do not meet the costs. Re-gardless, our commitment to their care will not be compromised. Our members are our highest priority.”

Per Member Per Month Analysis

Revenues

As mentioned previously, when the financial figures are divided by member months (the combined total of month ending member-ship for each nine month period), a monthly average is obtained that is valuable when comparing finan-cial and membership results.

Calendar Year-to-Date Revenue per member per month compari-sons reveal the extent to which a plan has negotiated higher per cap-ita premiums with its customers. It can also help explain changes to a plan’s demographic mix. For example, several plans referenced the State of California’s decision to mandate Seniors & People with Disabilities into managed care. An influx of this higher cost popula-tion results in higher per member per month revenue even if the plan

didn’t raise premiums on other members.

Administrative Expenses

Health plan administrative costs are usually under the microscope. Critics examine administrative costs for high salaries, marketing costs, and travel and entertainment expenses. However, it’s important to note that administrative costs for the large plans make up only 10% or so of total revenues. Using 10% as an average, even a 20% reduc-tion in administrative costs would lower premiums by just 2%. The ability of the typical plan to lower administrative costs by even 10% is difficult without impacting the plan’s ability to function efficient-ly.

Net Income

A change in per member per month net income is a key indicator of the decisions a plan will make in the future. If the reduction is signifi-cant, plans will either raise rates or change their product mix. If a plan can’t raise rates, because they offer governmental products and the rate is “take it or leave it,” they could decide to exit the product line al-together. With the majority of the plans showing lower per member per month net income than the pri-or year, conventional wisdom sug-gests premiums will rise more than usual and plans could exit product lines in 2012.

David Peel is the Publisher and Editor of the California Health-care News (www.cahcnews.com). He has held executive positions at several health care organizations throughout his twenty five year ca-reer.

-4-

Tabl

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-5-

Volume 4, Issue 1Ta

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-6-

Healthcare Administration California Healthcare News | January 2012 | cahcnews.com

Infection Prevention Goals Build Culture of Safety at Adventist’s White Memorial Medical Center

“We went off-site for a fullday of Lean work on

pressure ulcers.”

Lynne Whaley, CNOWhite Memorial Medical Center

By Nora HaileContributing EditorCalifornia Healthcare News

White Memorial Medical Center, a member of Adventist Health’s not-for-profit, faith-based health system, has had notable success with safety initiatives. One of many California Hospitals that have taken on quality improve-ment measures focused on patient safety, the Los Angeles center uses a model adopted in 2008 from that of the Johns Hopkins Culture of Safety model. As part of that stan-dard, White Memorial’s hospital governing board established a sub-committee called “Clinical Quality and Patient Safety” which exam-ines patient safety and clinical out-comes on a monthly basis, keeping everyone on their toes.

One of the safety and preven-tion initiatives White Memorial chose to tackle was the preven-tion of pressure ulcers (commonly known as bedsores). The painful condition, where tissue dies due to pressure against the skin, decreas-ing blood flow, can lead to seri-ous complications such as sepsis, cellulitis, bone and joint infec-tions, or even an aggressive form of cancer requiring surgical treat-

ment. According to Lynne Whal-ey, White Memorial’s CNO, “We joined CALNOC (Collaborative Alliance for Nursing Outcomes) in 2006, and began comparing our standing to their data. We realized we weren’t stellar around pres-sure ulcer prevention.” So began

their corrective course.

Though initial efforts brought some improvements, the traction wasn’t there. Then came the light bulb.

“We went to an IHI Conference,” said Whaley. “There was a track particular to skin care and patient safety, with research around skin as an organ.” The White Memo-rial and Adventist Health attend-ees took the information back and worked it into a plan, then sched-uled a team retreat. “We went off-site for a full day of Lean work on pressure ulcers – representatives from nursing staff, physicians, Board and executive leadership – all came together with this specific prevention in mind.” The team de-veloped action plans that day and returned to engage the other care-givers as they implemented the plans.

Gloria Bancarz, CNO for Adven-tist Health Corporation, talked about the experience, “We realized that we needed to focus on this as a health system. White Memorial and several other facilities had done so individually. We decided that as a collaborative group we could more effectively assist each other in the prevention process.” Each facil-ity identified a point person, or Wound Care Champion. Working together, the facilities developed standards and policies. Through the corporate IT department, they

-7-

Volume 4, Issue 1

“We realized that we neededto focus on this asa health system”

Gloria Bancarz, CNOAdventist Health Corporation

built in screening tools, includ-ing a risk assessment based on the Braden Skin Assessment Scale, a nationally known, evidence-based assessment. An all-facilities mat-tress fair looked at appropriate mattresses and proper overlays for various levels of care and at-risk patients. As the new practices were implemented, the system’s hospitals shared which initiatives worked, discovering obstacles to-gether and sharing lessons learned. The network made significant safety strides, as Bancarz related, “Within a two-year period, we saw a 65% improvement in our rate. Engagement across the system and within the staff built that success.”

Accolades are much deserved. White Memorial and the larg-er Adventist Health organiza-tion have changed the way every medical team member looks at a wound. Treating the skin as an or-gan means understanding how it is affected by nutrition, hydration, treatment, hygiene – and realizing how much depends on correctly recognizing risk at the outset. “We have nurses who are wound care specialists,” said Whaley. “So if the admitting nurse conducting the Stage assessment sees anomalies

or is unsure at what level to Stage the patient, they have an expert to go to for those complexities.” Then there’s the Wound Care Commit-tee, made up of physicians from all

areas. They look at every skin care issue and work the prevention pro-gram to keep patients safe. Plus, the technology tools provide con-stant feedback, as Whaley points out, “We know right away if we’re tracking to success or not, thanks to real-time data.”

“Our infection prevention achieve-ments are team triumphs,” added Bancarz. “The physicians make sure the evidence-based orders on their side link with what’s happen-ing on the nursing side.” That in-cludes other safety and infection prevention programs, such as cen-tral line infection prevention, ven-tilator associated pneumonia and catheter related UTIs – all of which the Adventist and White Memorial have addressed successfully.

And always, the teams focus on the positive outcomes. At White Memorial, where the outcomes include an 85% reduction in pres-sure ulcers since 2009, there’s good cause. In 2008, the Southern California Patient Safety Collab-orative recognized them for com-pletely eliminating severe (Stage 3 and 4) bedsores. Then in a 2008 on-site, unannounced accredita-tion survey, the Joint Commission granted the Gold Seal of Approv-al. “We celebrate the successes,” Whaley said. “For our patients and families, and the good nurs-ing care they’ve been given. It’s a constant journey.”

Nora Haile can be reached at [email protected].

Time to bring in outside help?The Consultant Marketplace, located on the California Healthcare News web site, is where over 50 companies that specialize in providing services or products to healthcare organizations are found. Visit cahcnews.com/consultant to learn more.



-8-

To advertise call 425-577–1334 Visit cahcnews.com to see all

available jobs.To advertise call 425-577–1334 Visit cahcnews.com to see all

available jobs.Career Opportunities To advertise call 425-457-4316

Visit cahcnews.com to see all available jobs.

Housekeeper (Per Diem)(Pleasant Hill, CA)

POSITION SUMMARY: This position reports to the Bruns House Director and is responsible for providing for the overall cleanliness of the Fa-cility and prepares meals for the residents of the Bruns House, Inpatient Facility.

POSITION REQUIREMENTS: A team player who displays confidence and the ability to work independently with little supervision. Must dem-onstrate initiative, dependability and good judg-ment. Must have excellent interpersonal and communicational skills. Able to demonstrate ex-cellent organizational skills and have knowledge of housekeeping and kitchen infection control guidelines.

EXPERIENCE AND EDUCATION: 1 year of housekeeping experience in hospital envi-ronment; healthcare or related area is helpful. High school diploma (or equivalent) is required.

To learn more and apply visit our web site at www.hospiceeastbay.org/employment-opportunities/

Director, Compliance Prevention and Privacy Officer(San Dimas, CA)

The Director, Compliance Prevention Services and Privacy Officer provides strategic direction and tactical management with respect to the implementation of the auditing, monitoring and prevention com-ponents of Arcadian’s Compliance program. This includes delegation oversight activities, Fraud, Waste and Abuse activities and HIPAA/ Privacy. This position is responsible for the development and/or implementation of appropriate controls through monitoring to assess and ensure compliance with CMS and other regulatory requirements by Arcadian.

This is a highly visible role within the company in terms of dealing effectively with all departments. The position requires the ability to build positive and strong relationships with internal and external con-stituents, including Internal Audit (Protiviti).

Qualifications

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Rea-sonable accommodations may be made to enable individuals with dis-abilities to perform the essential functions.

Education and Experience

Bachelor’s degree (B. A.) from four-year College or university, Ad-vanced degree preferred. Medicare Advantage related experience or equivalent required. Experience with CMS’ Part C and D auditing and monitoring or equivalent required.

To apply and learn more visit

www.arcadianhealth.com/careers.html

Director, Case Management(Lynwood, CA)

Full Time - Day Shift

At St. Francis Medical Center, compassionate service means providing care with gentleness and kindness. It also guides our efforts to meet the healthcare needs of the whole person — body, mind and spirit. We invite you to consider this exciting opportu-nity to share our values and join our healing mission.

The Director of Case Management is responsible for the imple-mentation and ongoing development of the case management program. Responsibilities will include developing, planning and coordinating the activities of Utilization Review and Discharge Planning while ensuring departmental compliance with State and Federal regulations. Duties also include providing ongoing train-ing and leadership to staff.

The successful applicant must have extensive experience maxi-mizing reimbursements for Medicare/MediCal patients; a strong understanding of legal, compliance, risk and financial impact of case management decisions; and demonstrated proficiency in all aspects of UM, CM and Collaborative Care.

Requirements include 5+ years of recent acute care hospital-based case management experience (with 3 years at the Direc-tor level), CA RN license, BSN and current case management certification.

St. Francis team members enjoy professional growth and edu-cational advancement, as well as excellent benefits that include medical, dental and vision plans, plus generous paid time off, a tax-deferred annuity and a matched contribution retirement plan. For immediate consideration, please apply online at: www.stfrancismedicalcenter.org. EOE

Chief Medical Officer(Los Angeles, CA)

The Chief Medical Officer (CMO) is responsible for the oversight of clinical (medical, dental, behavioral health, and pharmacy) matters affecting The Sa-ban Free Clinic’s health services at all Clinic’s locations. The CMO is respon-sible for the provision of high quality care throughout the organization and oversees The Clinic’s Quality Management Program in conjunction with The Director of Operations. The CMO works collaboratively with The Clinic’s strate-gic partners including Cedars-Sinai, Kaiser Permanente, and other Residency Training Programs to oversee physician resident training. The CMO also over-sees care provided by staff and volunteer clinicians. The CMO directly super-vises the Associate Medical Director, the Director of Pharmacy Services, the Dental Director, the Director of Behavioral Health, and the Director of Nursing. The incumbent serves as an active member of the Executive Management Team. In addition, the CMO has been designated as the Acting Clinic Adminis-trator to act in the absence of the Co-Chief Executive Officers.Primary Qualifications:To perform effectively in this position the incumbent must have the following: Currently licensed as a physician in CA; Board certified in primary care spe-cialty (Family Medicine, Internal Medicine, OB/GYN). Current DEA License and BLCS Certificate. Minimum five years clinical experience in a community based medical setting with administrative and supervisory responsibilities. Knowledge of local, state and national healthcare issues and impact highly preferred. Previous implementation of electronic healthcare records is highly preferred. Strong leadership, delegation, and communication skills; Strong medical administrative skills especially around system design. Previous expe-rience in designing and implementing a medical home model highly preferred. Demonstrated ability to respond with sensitivity to people of diverse cultures and various lifestyles; Demonstrated ability to communicate effectively with lay volunteers, patients and with professionals from a variety of disciplines. Willingness to commit to the mission, philosophy and goals of the Saban Free Clinic.Submit resumes to the following:Mail:The Saban Free Clinic8405 Beverly Blvd.Los Angeles, CA, 90048Attn: Human ResourcesEmail: [email protected]: (323) 658-6773EOE

Director, Workers’ Compensation and Employee Safety

(Los Altos Hills, CA)Located in the beautiful and centrally located Redwood Shores area on the SF Peninsula, Daughters of Charity Healthcare System (DCHS) has an immediate opportunity for Director, Workers’ Compensation and Employee Safety.

The successful candidate will perform activities that assist the Daugh-ters of Charity Health System and its Local Health Ministries (LHMs) achieve system-wide strategies for the effective management of workers’ compensation claims and employee safety and loss prevention programs.

REQUIREMENTS: Registered Nurse diploma is preferred. Minimum of five (5) years of progressively responsible experience in managing workers’ compensation programs and or workplace safety program de-velopment. Certification/training provided by appropriate workers’ com-pensation/safety industry associations, or through other formal training/education programs is desired. Strong knowledge of legal, statutory and regulatory workers’ compensation rules and regulations, claim adminis-tration practices, and workers compensation cost-containment strategies. Familiarity with California, Federal, and other regulatory associate health and workplace safety requirements and resources for monitoring health care compliance issues. In-depth knowledge of health care workplace safety and accident prevention programs and resources; and worker’s compensation information management. Strong written and verbal com-munication skills and experience in program development, staff training, and information analysis and presentation. Must be able to set and orga-nize own work priorities and adapt to them as they change frequently.

EQUAL OPPORTUNITY EMPLOYER

APPLY ONLINE @ www.dochs.org under System Careers.

OR

EMAIL RESUME TO [email protected]

-9-





Clinical Risk Manager/Regulatory Compliance RN

(Fresno, CA)

Job Summary: Responsible for Risk Identification and Evaluation. Coordination of Corrective Action and providing education related to Risk Manage-ment Issues. Coordinates Risk Programs with all hospital departments and interfaces with legal coun-sel. Reporting real and potential risk situations act-ing as the Compliance Officer. Responsible for es-tablishing and monitoring methods to avoid and or reduce risk associated with patient care and servic-es. Works in conjunction with the CNO and Qual-ity Director to assist with oversight for Regulatory Survey’s in i.e. JCAHO, CMS and State Licensing.

Education and/or Experience: Completion of an ac-credited nursing program. BSN Preferred or equiva-lent and/or 3-5 years of Recent HealthCare Experi-ence in Risk Management

Certification and/or Licensure: California Regis-tered Nurse (RN) License. BLS Required.

To learn more and apply visit our web site at:

www.fresnosurgicalhospital.com

Medical Group Urgent CareOperations Manager

(Beverly Hills, CA)

Cedars-Sinai Medical Care Foundation, located in Bev-erly Hills, California, has an exciting opportunity for an experienced Operations Manager for the busy Urgent Care practice in the Cedars-Sinai Medical Group. Ce-dars-Sinai Medical Group is a dynamic multi-specialty medical group of over 100 physicians. The Urgent Care Operations Manager is responsible for managing all as-pects of the daily administrative and clinical operations including front, back office and medical records staff. Provides leadership, training, counseling and mentor-ing to staff. Demonstrated experience in communicating and interacting with physicians and senior management to ensure quality of patient care and service. Requires Bachelor’s degree in healthcare management or related field, 3 years management/supervisory experience pref-erably in a multi-specialty medical group setting, strong organizational and communication skills. Preferred can-didate will have supervisory experience in an Urgent Care setting.

For more detail and/or to apply, visit our Web site at: https://www.cedars-sinaimedicalcenter.apply2jobs.com and reference Job #4738.

Cedars-Sinai is an Equal Opportunity Employer that welcomes and encourages diversity in the workplace.

Assistant Unit Manager - Behavioral Health

(Lynwood, CA)Assistant Unit Manager – Behavioral Health

At St. Francis Medical Center, compassionate service means providing care with gentleness and kindness. It also guides our efforts to meet the healthcare needs of the whole person — body, mind and spirit. We invite you to consider this exciting opportu-nity to share our values and join our healing mission.

The successful applicant will work with department management to develop, implement, coordinate and evaluate the delivery of nursing care services to ensure quality care is being delivered to patients and families. Responsibilities include providing mana-gerial and administrative supervision, interviewing candidates for hire, scheduling staff, managing performance through coach-ing, providing annual performance reviews of staff and partici-pating in all required management meetings.

To be qualified for this position, you must have continuously progressive responsibility in management, strong clinical knowl-edge in clinical area, excellent written and verbal communication skills and proficient computer abilities.

Licenses/Certifications: Current CA Registered Nurse License (BSN preferred). Current BLS - AHA Certification.

St. Francis team members enjoy professional growth and edu-cational advancement, as well as excellent benefits that include medical, dental and vision plans, plus generous paid time off, a tax-deferred annuity and a matched contribution retirement plan. For immediate consideration, please apply online at: www.stfrancismedicalcenter.org. EOE

Nurse Manager(Hermiston, OR)

Current full-time, salaried exempt, Nurse Manager Position on busy 15 bed Medical Surgical Nursing department. The need exists due to previ-ous manager accepting another position within the organization.

This position is for a Nurse Manager for the largest department in this 25 bed Critical Access hospital in Hermiston, Oregon. Will Supervise approximately 45 FTE and work closely with an Assistant Manager and the VP of Nursing.

Position Requirements: Acceptable applicants will have minimum of five years prior managerial experience. Candidate parameters include:

A. Education. Required: Graduate of an accredited school of profes-sional nursing. Evidence of continuing education appropriate for a Medical/Surgical nurse manager. Desired: BSN in nursing, certificate in specialty area.

B. Experience. Required: Charge nurse or supervisory experience. De-sired: Previous manager experience.

C. Licenses, Certificates. Required: Current RN license in the State of Oregon, ACLS, PALS. Desired: Certification in specialty area preferred.

Compensation: Compensation for this salaried exempt position is based on experience with a salary range from $85,000 to $116,000 per year plus benefits including: medical insurance, dental insurance, Vi-sion insurance, Life insurance, Disability insurance, Liability insurance, Pension, paid vacation, holiday and sick leave. Other benefits include discounts and paid continuing education.

For more information please contact and send resume to:

Kelly SandersVP Human ResourcesGood Shepherd Medical Center610 NW EleventhHermiston, OR 97838(541) 667-3413(541) 667-3414 [email protected]

Major Gifts Officer(Whittier, CA)

Since 1959, Presbyterian Intercommunity Hospital of Whittier has been committed to building a mutually supportive health care team consisting of patient care givers, medical staff, volunteers and the board of directors that have ensured our local population the highest quality of medical services in Los Angeles County.

Our Foundation department seeks a Major Gifts Officer.

The Major Gifts Officer will primarily be responsible for maintain-ing, identifying, managing and cultivating individual prospects. He/she will oversee the outreach to PIH Foundation donors and prospects and will regularly communicate with donors through phone calls, letters and emails. This person will establish sys-tems for donor research and will review systems regarding key functions, such as gift processing, acknowledgment letters, and production of internal and external reports and analyses support-ing these functions.

Requirements include: Bachelor’s degree required. Minimum five (5) years of experience in direct major gift solicitation/planned giving with hospital, health agency or similar organization with demonstrated advancement of position and responsibilities. Excellent written and verbal communication skills. Experience and ability to cultivate donors. Ability to produce grant propos-als, and financial and narrative reports, spreadsheets. Computer skills, including proficiency with: Microsoft Office, Publisher, Outlook, and database management skills (Blackbaud’s Raisers Edge and/or Maestro)

Beyond the benefits that come with working for the area’s lead-ing community health care provider – one that also recognizes the need to ensure patient safety and comfort – you’ll enjoy an extremely competitive compensation and benefits package. Plus, we use team concepts to encourage professional growth and development.

Please apply online at www.pih.net, or [email protected].

Director of Managed Care(Los Angeles, CA)

Currently seeking a Director of Managed Care.

The Director of Managed Care will be responsible for contract management of facility, professional and an-cillary agreements. Negotiates contracts to assure the optimum balance of progressive growth and profitability. Coordinates closely with various departments as well as contracted entity.

Qualifications:

Relevant Bachelors Degree in Accounting or Business Administration from an accredited university or college.

Eight (8) or more years of direct or equivalent experi-ence in complex healthcare entity financial manage-ment.

Highly effective written, verbal and presentation com-munication skills.

Effective use of diplomacy and candor with supervisors and customers.

Working knowledge of human resources, and research business and economic databases.

Demonstrated ability to produce clear and concise re-ports for discernment and direction by senior leadership.

Ability to competently use personal computers and tra-ditional organizational software such as Microsoft Word, Excel, PowerPoint and Access.

Apply today to join a talented group of Directors to be-come an active member of our experienced Adminis-trative Team. Competitive compensation and excellent benefits offered to the right candidate. Send resume to [email protected] or call 323-906-6050 to speak to recruiter.

Volume 4, Issue 1




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Informatics Specialist(Pleasant Hill, CA)

In collaboration with all clinical departments and relevant support departments, the Clinical Informatics Manager devel-ops, implements, and supports the core functions of the clini-cal information system to support cost-effective, high quality, and safe patient care. These core functions include: computer-based provider order entry, result retrieval, clinical documen-tation, electronic prescribing, and clinical decision support.

Job Qualifications: The ideal candidate will have a Bach-elor’s degree in a work-related field/discipline (RN, PT, etc.) from an accredited college or university. Experience: Two years of progressively responsible and directly related work experience (hospice preferred) as a licensed healthcare pro-vider. Knowledge of current issues and trends in health care and clinical operations in a health care system. Knowledge of redesigning clinical processes to improve efficiency and pa-tient care, preferably in conjunction with the implementation of a clinical information system. Must have knowledge of information systems, clinical software, and computer appli-cations used in a health care setting. Knowledge of Windows-based office software, computers and operating systems. Ability to foster effective working relationships and build consensus with other departments and external vendors, and to communicate complex concepts in simple form to cross-functional departments or teams.

Please send your resume and salary requirements to [email protected]

Case Management Nurse(Cerritos, CA)

The Case Management Nurse (CMN) for Case Man-agement and the Chronic Care Improvement Program (CCIP) is responsible for; 1) Senior and at risk popula-tion to include catastrophic/high risk/frequent ER utilization management, 2) Coordination of care with member, family and physician care team, (3) maintaining statistics on CM processes, (4) promoting health education and quality pa-tient care outcomes while supporting appropriate utilization/resource management.

Essential duties include: Oversee referrals; telephone in-terviews of members to identify risk factors and the need for case management; initiates and/or coordinates health plan and community services; develops and implements both short and long term goals; maintain tracking of interventions and outcomes; case presentation and statistics according to policy or request; collaborates with Inpatient Case Manager to assist with discharge planning; assists with the review and development of new protocols, procedures and guidelines.

Education and/or Experience: Current, Active and Unre-stricted California Registered Nurse or Licensed Vocational Nurse license; two to three years related experience in a managed care setting; Knowledge of Medicare Managed Care Plans; Computer Skills: Word, Excel, Microsoft Out-look; Experience with the application of UM criteria (i.e., Mil-liman Care Guidelines, CMS National and Local Coverage Determinations, etc.); Bilingual (English/Spanish)

For complete job description & qualifications visit our web-site at: www.citizenschoicehealth.com.

To apply, email resume with salary history to: [email protected] or fax (562) 207-4625

Occuptional Therapist or Activities Director

(Brewster, WA)Three Rivers Hospital (formerly Okanogan Douglas Hospital) is seeking an OT or Activities Director to oversee the hospital’s Swing Bed Pro-gram. Current WA State Occupational Therapist License or Recreational Therapist Certification. Days and hours will vary; occasional weekend work – Per Diem Status.

Interested Candidates may apply in person or by mailing their resume to:

Okanogan Douglas District HospitalAnita Fisk, Director of Human Resources

PO Box 577Brewster, WA 98812

(509) 689-2517 x 3343

Or for quicker submission:Send resume to: [email protected] on-line at: www.oddh.org

Position open until filledEOE





Volume 4, Issue 1

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Home Health Aide(Pleasant Hill, CA)

POSITION SUMMARY: Reporting to the Team Manager or Director of In-Patient Unit, this po-sition is responsible for carrying out the duties assigned in order to increase the patient’s level of comfort and to maintain personal hygiene and a safe healthy environment. Although the Home Health Aide reports to a primary manager, HEB expects the Home Health Aide may work in more than one program or department and assignments are given to best meets the needs of our patients.

EXPERIENCE AND EDUCATION: Must com-plete the Home Health Aide competency test with a passing score of 75% or better. Must have completed an official Home Health Aide training course and have a Home Health Aide Certificate issued by the State Department of Public Health. If there has been a 24 month lapse in furnishing services, the individual must complete another state approved Home Health Aide program be-fore providing services. Valid CPR certification.

To learn more and apply visit our web site at www.hospiceeastbay.org/employment-opportunities/

IT TAKES A SPECIAL FOCUS TO BE THE BEST IN THE WEST.

Manager – Revenue Cycle Care Coordination

In this position, you will manage revenue cycle activities, utilization reviews, appeals and denials, retrospective reviews, level of care issues, and the the EHR program.

Our ideal candidate should have a BSN/MSN and California RN licensure. Management experience, broad clinical expertise, knowledge of Medicare, Medi-Cal and commercial insurance are required.

For more information and to learn about our benefits, please apply online at http://hr.healthcare.ucla.edu and reference Job Code H59387 or contact Sheri Monsein at [email protected]. EOE

Coalinga Regional Medical Center is nestled in the coastal mountain range of California, just 70 miles from the Pacific Coast and 60 miles west of Fresno, California.Coalinga Regional Medical Center is the single most important com-ponent of the health care delivery system in the City of Coalinga. Established in 1938, the hospital provides the following essential health care services to the community:• Acute Care• D.O.T. Exams• Emergency Medicine• Industrial Medicine• California Licensed Laboratory• Physical Therapy• Radiographic and Fluoroscopy Studies - MRI - CT Scans - Mammography - Sonography• Respiratory Therapy• Skilled Nursing Facility

We are currently seeking the following key positions:• Clinical Lab Scientist• LVN Coordinator - Rural Health

Clinic• LVN – SNF • Nurse Practitioner• Physician’s Assistant• Registered Nurse - ER• RN Supervisor, SNF• Speech PathologistFor job postings and applications, please visit: www.coalingamedicalcenter.com Email: [email protected] Phone: 559.935.6420 Fax: 559.935.6512

Coalinga Regional Medical CenterServing the Community since 1938

Nurse Manager - ICU(Lynwood, CA)

At St. Francis Medical Center, compassionate service means provid-ing care with gentleness and kindness. It also guides our efforts to meet the healthcare needs of the whole person — body, mind and spirit. We invite you to consider this exciting opportunity to share our values and join our healing mission.

The successful applicant will work closely with the Clinical Director to develop, implement, coordinate and evaluate the delivery of nursing care services in units under their responsibility. Duties will include recruiting, training, evaluating and managing staff while collaborating with department heads to meet St. Francis Medical Center strategic objectives. This position will also share in budgetary responsibilities and represent the unit on various hospital committees.

The position requires managing staff that are providing care and ser-vice to an adolescent through geriatric patient population. The suc-cessful applicant will be responsible for ensuring that staff is providing age appropriate care in a manner that demonstrates an understanding of the functional and developmental age of the individual served.

To be qualified for this position, you must have a Bachelor Degree in Nursing (MSN preferred), five years recent experience in Critical Care, proven management expertise, effective written/verbal skills and basic computer abilities. Bilingual (English/Spanish) applicants are preferred.

Licenses/Certifications: Current CA Registered Nurse license. Cur-rent BCLS-C (AHA) card. Current ACLS.

St. Francis team members enjoy professional growth and educational advancement, as well as excellent benefits that include medical, dental and vision plans, plus generous paid time off, a tax-deferred annuity and a matched contribution retirement plan. For immediate consider-ation, please apply online at: www.stfrancismedicalcenter.org. EOE

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