Care Management Supervisor

4 weeks ago

Miami FL USA, United States Leon Health Full time

The Care Management Supervisor will support the Health Services Department in achieving clinical quality and service objectives by facilitating the Case Management processes.

In addition, directs and coordinates activities associated with the day-to-day operations of the Case Management team under the direction of the Manager of Case Management.

Key Responsibilities:

  • Operational Oversight: Supports the oversight of the day-to-day operations of clinical, non-clinical, and administrative staff, ensuring seamless execution of tasks and duties.
  • MOC Monitoring: Monitors adherence to MOC activities, including HRA, individualized care plans, interdisciplinary care teams, and care transitions, to ensure optimal patient outcomes.
  • Reporting and Analytics: Monitors assigned daily operational reports for accuracy and timeliness, providing insights to inform data-driven decision making.
  • Task Management: Distributes and assigns tasks to Case Management staff as directed, ensuring timely completion and effective resource allocation.
  • Phone and Fax Management: Monitors Case Management phone and fax queues on a daily basis, ensuring prompt response to member inquiries and concerns.
  • Collaboration and Communication: Coordinates with leaders of Utilization Management to address Care Management or Utilization Management concerns or barriers, fostering a culture of collaboration and open communication.
  • Process Improvement: Identifies process improvement opportunities and assists in the development, implementation, and monitoring of action plans based on identified Care Management metrics, driving continuous quality improvement.

Requirements:

  • Knowledge and Experience: Knowledge of Dual Eligible Special Needs Plans, Centers for Medicare and Medicaid Services (CMS), and Florida Medicaid, as well as understanding of Case Management best practices.
  • Leadership and Communication: Ability to multi-task, prioritize work, and adjust based on business/department needs, with effective communication (listening, verbal, and written) skills.
  • Technical Skills: Proficient in Microsoft Word, Excel, and Outlook, with good organization and attention to detail.

Qualifications:

  • Experience: 2-5 years of experience in Case/Care Management, with problem-solving proficiency and the ability to systematically analyze problems, draw relevant conclusions, and devise appropriate courses of action.
  • Language Skills: Fluent in English and Spanish.

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