Case Management Supervisor
4 weeks ago
Job Summary
The Case Management Supervisor will oversee the utilization review process, ensuring that patients receive the necessary level of care in the correct setting. This role requires strong communication skills, critical thinking, and the ability to work with minimal supervision.
Key Responsibilities
- Supervise a small staff, assigning, reviewing, and evaluating their work.
- Manage the utilization review process, reviewing authorizations for correct type of stay, managing the correct level of care in the correct setting, and managing and appealing claims that have been denied.
- Manage the discharge planning process, ensuring that patients move to the appropriate level of care after discharge.
- Communicate medical and reimbursement policies to surgeons, clinicians, and non-clinicians in a timely manner.
Requirements
- RN license required.
- BSN required; CCM strongly preferred.
- Minimum of 5 years of previous case management experience in a hospital setting.
- Ability to be assertive with persuasive communication skills, action-oriented, organized, and efficient with time.
- Ability to be compassionate to people and their situations.
- Critical thinking skills, decisive judgment, and the ability to work with minimal supervision while meeting firm deadlines.
- Communication skills necessary to be a good listener and speak in an understandable way.
- Previous supervisory experience preferred.
Physical Demands
- The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job.
- Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Work Environment
- The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job.
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