Case Management Supervisor
4 weeks ago
Job Summary
The Case Management Supervisor will oversee the utilization review process, ensuring that patients receive the appropriate level of care in the correct setting. This role will also manage the discharge planning process, ensuring a smooth transition for patients moving to the next level of care.
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 patients move to the appropriate level of care after discharge.
- Communicate medical and reimbursement policies and regulations 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.
- Understands the importance of teamwork when achieving desired results.
- Understands basic CMS guidelines and has experience working with payor specific medical policies and reimbursement methodologies.
- Understands how to use InterQual or Milliman to determine the appropriate level of care.
- Understands basic coding principles and chargemaster operations.
- Ability to be assertive with persuasive communication skills; action oriented.
- Ability to be organized and efficient with time.
- Ability to be compassionate to people and their situations to work with them in a positive way that will help them make positive forward strides.
- 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.
Work Environment
- The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job.
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.
-
Case Management Supervisor
3 weeks ago
Addison, Texas, United States Surgery Partners Full timeJob SummaryThe 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 ResponsibilitiesSupervise a small staff, assigning, reviewing, and...
-
Home Health Case Manager
4 weeks ago
Addison, Texas, United States Cantex Continuing Care Network Full timeJob Title: Home Health Case ManagerCantex Continuing Care Network is seeking a skilled Home Health Case Manager to join our team. As a Home Health Case Manager, you will be responsible for conducting all aspects of supervision and management of patient care, including LVN and HHA supervision, case conferences, and discharge planning.Key...
-
Clinical Case Manager
3 weeks ago
Addison, Texas, United States Surgery Partners Full timeJob SummaryThe Clinical Case Manager - RN will work with physicians and other healthcare professionals to develop and implement patient care plans from admission to discharge. This role requires strong communication and critical thinking skills, as well as the ability to work effectively in a fast-paced environment.Key ResponsibilitiesPerform continuous...
-
Annuity Case Specialist
4 weeks ago
Addison, Texas, United States National Life Group Full timeJob SummaryWe are seeking an Annuity Case Specialist to join our team at National Life Group. As an Annuity Case Specialist, you will be responsible for assessing financial risk factors and determining appropriate ratings for annuity applications, processing applications in workflow management systems, collaborating with the team, and effectively...
-
Annuity Case Associate
4 weeks ago
Addison, Texas, United States National Life Group Full timeAbout the RoleWe are seeking a highly skilled and detail-oriented Annuity Case Associate to join our team in Texas. As a key member of our underwriting team, you will be responsible for ensuring the timely and accurate processing of life insurance applications.Key ResponsibilitiesAssess and evaluate non-medical and financial risk factors for life insurance...
-
Regional Nutritional Account Manager
3 weeks ago
Addison, Texas, United States Sentido Health Full timeJob SummaryWe are seeking a highly skilled Regional Nutritional Account Manager to join our team at Sentido Health. As a Registered Dietitian, you will be responsible for providing sales support to key accounts, direct patient education, and working with key accounts to identify and establish individualized documentation processes to manage our current and...
-
Annuity Case Associate
3 weeks ago
Addison, Texas, United States National Life Group Full timeJob SummaryAt National Life Group, we're seeking a highly skilled Annuity Case Associate to join our team in Texas. As a key member of our team, you will be responsible for delivering exceptional customer experiences to our distribution channels, ensuring life insurance applications are processed with speed, accuracy, and caring curiosity.Key...
-
Blood Collection Supervisor
4 weeks ago
Addison, Texas, United States Carter BloodCare Full timeJob SummaryThe Mobile Site Supervisor is responsible for ensuring the smooth and efficient operation of the donor center. This includes determining donor acceptability, performing sterile venipuncture, and providing excellent customer service.Key ResponsibilitiesAssist in the management of donor flow and ensure compliance with regulations and standard...
-
Warehouse Operations Supervisor
4 weeks ago
Addison, Texas, United States Aramark Full timeJob SummaryThe Warehouse Lead Supervisor is responsible for overseeing the daily operations of the warehouse, ensuring that all products are received, stored, and shipped in a timely and accurate manner. This role requires strong leadership and communication skills, as well as the ability to work effectively in a fast-paced environment.Key...
-
Call Center Operations Manager
4 weeks ago
Addison, Texas, United States Lehman Consulting and Recruiting Full timeJob OpportunityLehman Consulting & Recruiting is seeking a Call Center Operations Manager to lead our team of customer service representatives.Key Responsibilities:Provide strategic leadership to front-line supervisors, ensuring operational and coaching practices are implemented to drive performance results and employee development.Determine call center...
-
Billing and Collections Supervisor
3 weeks ago
Addison, Texas, United States Behavioral Innovations Full timeJob SummaryWe are seeking a highly skilled and detail-oriented Billing and Collections Supervisor to join our team at Behavioral Innovations. As a key member of our revenue cycle team, you will be responsible for coordinating and performing various administrative duties related to provider credentialing and enrollment.Key Responsibilities:Process...
-
Physical Therapy Assistant
3 weeks ago
Addison, Texas, United States Surgery Partners Full timeJob Summary:The Physical Therapy Technician position at Surgery Partners will be responsible for assisting the Physical Therapist or Physical Therapy Assistant with daily patient physical therapy treatment. This role will provide support with patient care based on instructions from the P.T. or P.T.A., as well as assist with maintenance and updating of...
-
Home Health Nurse
1 day ago
Addison, Texas, United States Aveanna Healthcare Full timeAveanna Healthcare is a leading national provider of home health services to medically fragile children and adults. As a Home Health Nurse, you will play a crucial role in providing high-quality patient care and making a positive impact on their lives.We are currently seeking experienced nurses to join our team as Private Duty Nurses. You will be responsible...
-
Product Manager
3 weeks ago
Addison, Texas, United States Tanium Full timeAbout the RoleWe are seeking a highly skilled Product Manager to join our Platform team. As a Product Manager, you will be responsible for the development and business success of Tanium products that are part of the core platform.Key ResponsibilitiesOwn the delivery of the product roadmap from ideation to launch in partnership with the engineering...
-
Electrical Project Manager
3 weeks ago
Addison, Texas, United States Petri Electric, Inc. Full timeJob SummaryWe are seeking an experienced Electrical Project Superintendent to join our team at Petri Electric, Inc. As a key member of our construction team, you will be responsible for overseeing electrical construction and renovation projects from start to finish.Key ResponsibilitiesCollaborate with project managers to procure necessary materials and...
-
Operations Manager
4 weeks ago
Addison, Texas, United States Marriott Hotels & Resorts Full timeKey ResponsibilitiesAs an Operations Supervisor at Marriott Hotels & Resorts, you will be responsible for completing designated cashier and closing reports in the computer system. This involves reviewing shift logs and daily memo books to document pertinent information in logbooks. Additionally, you will need to contact appropriate individuals or departments...
-
Pediatric Respiratory Therapy Department Manager
4 weeks ago
Addison, Texas, United States Medical City Dallas Full timeJob SummaryWe are seeking a highly skilled and experienced Manager of Pediatric Respiratory Therapy to join our team at Medical City Dallas. As a key member of our respiratory care services department, you will be responsible for managing and coordinating activities to ensure the highest level of patient care and satisfaction.Key ResponsibilitiesManage and...
-
Litigation Secretary
4 weeks ago
Addison, Texas, United States Jump Start Consulting Full timeJob Summary:The Litigation Secretary provides administrative and clerical support to attorneys in a legal office, primarily focused on managing litigation cases. This role involves preparing legal documents, scheduling court dates, maintaining case files, and communicating with clients and court officials.Key Responsibilities:Prepare and file legal...
-
Addison, Texas, United States ServiceNow Full timeJob DescriptionServiceNow is a leader in digital transformation, helping organizations streamline operations and deliver exceptional experiences. We are experts in leveraging ServiceNow's powerful platform to drive business value, and we are looking for a passionate and strategic thinker to join our team as a ServiceNow Business Process Consultant with Sales...
-
Legal Secretary
3 weeks ago
Addison, Texas, United States Jump Start Consulting Full timeJob Summary:The Litigation Secretary provides administrative and clerical support to attorneys in a legal office, primarily focused on managing litigation cases. This role involves preparing legal documents, scheduling court dates, maintaining case files, and communicating with clients and court officials. This is an in-office position, and attendance is...