Supervisor of Case Management
4 days ago
We are seeking a highly skilled and experienced Supervisor of Case Management to join our team at Valenz. As a key member of our Care leadership team, you will play a critical role in ensuring that our members receive high-quality care and are effectively managed across the continuum of care.
Key Responsibilities- Team Leadership: Supervise a team of Case Managers, providing guidance, support, and training as needed to ensure the delivery of high-quality, patient-centered care.
- Policy Development: Work with leadership to develop and implement case management policies, procedures, and guidelines that promote the delivery of high-quality care.
- Compliance: Ensure compliance with regulatory and accreditation standards, including Medicare, Medicaid, and URAC, as well as CMSA's Standards of Practice, state, local, and federal laws.
- Data Analysis: Monitor and analyze data on team productivity, patient outcomes, utilization, and cost savings to identify opportunities for improvement.
- Care Coordination: Collaborate with members, healthcare providers, and clients to ensure effective and efficient care coordination and communication across the healthcare continuum.
- Escalation Management: Serve as a point of contact for escalation issues and attend client calls or meetings when necessary.
- Clinical Utilization Reviews: Oversee the team's clinical utilization reviews, assessments, and documentation to ensure quality and determine patients' needs for appropriate, measurable outcomes.
- Quality Improvement: Participate in quality improvement initiatives and committees to promote continuous quality improvement.
- Team Development: Provide continuous coaching, development, education, and training to the internal team, including during the onboarding process and as needed when additional support or education is required.
- Experience: 5+ years of experience in case management or a related field.
- Leadership Experience: 2+ years of experience supervising or leading a team of case managers.
- Certifications: Current RN licensure in residing state – compact a plus, CCM—Certified Case Manager certification, or willingness to obtain.
- Education: Bachelor's degree in Nursing or related field.
- Skills: Strong aptitude for relationship building with a highly effective communication style, ability to work in a fast-paced, detailed, deadline-driven environment, excellent computer skills in data transformation, visualization, and cross-functional collaboration.
- Master's Degree: Master's degree in Nursing or related field preferred.
- Industry Experience: Experience within the health insurance and Cost Savings industries.
- Bilingual: Bilingual strongly preferred.
At Valenz, we are committed to delivering on our promise to engage early and often for smarter, better, faster healthcare. We want everyone engaged within our ecosystem to be strong, vigorous, and healthy. You'll find limitless growth opportunities as we grow together.
We offer a range of benefits, including:
- Generous Benefits: Generously subsidized company-sponsored Medical, Dental, and Vision insurance.
- Spending Accounts: Spending account options: HSA, FSA, and DCFSA.
- Retirement Plan: 401K with company match and immediate vesting.
- Flexible Work Environment: Flexible working environment.
- Paid Time Off: Generous Paid Time Off to include Vacation, Sick, and Paid Holidays.
- Paid Leave: Paid maternity and paternity leave.
- Community Giveback: Community giveback opportunities, including paid time off for philanthropic endeavors.
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