Medical Supervisor RN

19 hours ago


Chula Vista, California, United States COMMUNITY HEALTH GROUP Full time
Job Summary

Community Health Group is seeking a highly skilled Medical Supervisor RN to lead our High Risk Case Management program. As a key member of our team, you will be responsible for supervising Clinical Case Managers and ensuring the optimal delivery of proactive and collaborative case management and care coordination activities.

Key Responsibilities
  • Supervise and train case management and care coordination staff to achieve program goals and objectives.
  • Develop and implement metrics to evaluate staff performance and productivity.
  • Manage and coordinate care for high-risk members to reduce hospital admissions, readmissions, and emergency room visits.
  • Collaborate with interdisciplinary care teams and contracted physician groups to establish member care needs.
  • Provide guidance and support to case managers and care coordinators with complex cases.
  • Work with the Health Care Services management team to develop and implement interventions to enhance member outcomes and quality metrics.
Requirements
  • Graduate from an accredited school of nursing or clinical related field.
  • 2 years' experience as a high-risk case manager and 1 year in a managed care environment, hospital discharge planning, or outpatient clinic.
  • Knowledge of population health, care management clinical operations, and management expertise in business planning, process improvement, budget administration, and personnel management.
  • Proficiency in Microsoft programs, including Word and Excel.
  • Familiarity with managed care principles, CPT, ICD-10, HCPCS coding, and inpatient and outpatient medical review guidelines.
What We Offer

Community Health Group is an equal opportunity employer committed to diversity and inclusion. We prohibit discrimination and harassment based on protected characteristics. Our organization is dedicated to providing a work environment that is free from bias and promotes equal opportunities for all employees.



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