Certified Woman & Minority Owned

Case Management Suprevisor


Reference Number: RKPACM21001

Case Management Suprevisor
experience  Not Disclosed
location  Philadelphia, PA
duration  4.0 Months
salary  Not Disclosed
jobtype  Not Disclosed
Industry  Pharmaceutical
Job Description


Case Mgmt Supvr

Job Summary:

Accountable for service delivery, staff supervision, performance management, recruitment, orientation, staffing and scheduling. Collaborate with the Manager in department planning, evaluation, training and development, performance improvement and budget management activities. Provide consultation and training within the hospital and in the community and will represent the department at appropriate forums to achieve the mission and goals of the organization. In collaboration with the Manager, focus on data collection and trending as it relates to payment denials. Collaborate with the business office staff regarding denials, appeals process, and clarification of medical necessity issues surrounding bill payment issues. Assures compliance with contract from case management perspective. Oversees, evaluates and assigned day-to-day operations of Case Management Department and assists with departmental staffing as needed. Meets with nurse managers, and social workers on an ongoing basis to assure a collaborative approach between the nursing, social work and case management coordinators.

Job Responsibilities

• Provides direct supervision of staff in assigned areas of responsibility including training, development, and recognition and performance management.
• Collaborates with Manager in providing leadership and management of all departmental operations including day-to-day activities, planning and performance management.
• Participates in the establishment and implementation of departmental goals.
• Interviews prospective candidates for departmental positions and makes recommendations about hiring to the director.
• Implements plans for the orientation and mentoring of new staff in the department

Skills

Additional Technical Requirements

Working knowledge of JCAHO requirements preferred

Medicare and Medical Assistance Guidelines preferred.

Excellent clinical and management skills.

Ability to make sound, clinical judgments in a fast paced environment.

Leadership skill.

Ability to work collaboratively with medical staff.

Excellent analytical skills. Knowledge of managed care admission process (i.e. verification of benefits, admissions notification).

Knowledge of Interqual Guidelines.

Excellent communication skills and demonstrated organizational skills.

Ability to work effectively with all departments and all levels of the client professionals.

Ability to work independently or within a team structure.

Must be very organized and able to work independently.

Ability to establish priorities among multiple needs, meet deadlines and maintain standards of productivity.

Knowledge of managed care admission process (i.e. verification of benefits, admissions notification).

Ability to effectively negotiate with internal and external providers of patient care services.

Sound problem solving skills.

Excellent customer service orientation and strong interpersonal skills.

Computer skills and a working knowledge of Word, Excel and Access

Education

Required Licenses, Certifications, Registrations

• Must be a licensed registered Nurse in the State of Pennsylvania, or have a temporary practice permit

Required Education and Experience

Required Education: Bachelor of Science in Nursing

Required Experience:

• Five (5) years clinical nursing experience

Preferred Education, Experience & Cert/Lic

Preferred Experience:

• Five (3) years of case management experience

• Three (3) years of experience in home care with management experience

• Three (3) years of management experience.

Skills and Experience

The Skills and Experience match parameters for the candidate are parsed from the Duties, Skills, and Education.

Required Skills

REGISTERED NURSECASE MANAGEMENTPROBLEM SOLVINGCUSTOMER SERVICEVERY ORGANIZED

level 3 - COVID Vaccine required
VIVA is an equal opportunity employer. All qualified applicants have an equal opportunity for placement, and all employees have an equal opportunity to develop on the job. This means that VIVA will not discriminate against any employee or qualified applicant on the basis of race, color, religion, sex, sexual orientation, gender identity, national origin, disability or protected veteran status.

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