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Case Management Supervisor

Location : Lander WY 82520
Job Type : Direct
Hours : Full Time
Travel : No
Relocation : No
Job Industry : Healthcare - Health Services
Job Category : Healthcare - Other

Job Description :


A self-directed and assertive registered professional nurse with a clear understanding of the global picture of care facilitation. 




The CM Supervisor provides leadership, direction, and coaching to the healthcare team with a primary focus on matching patient care needs to the appropriate admission or continued stay status through the use of evidence-based tools, physician engagement and clinical expertise. 




The purpose of this focus is to ensure the patient stays at the appropriate care level and ensures medically necessary adjustments are made that promote quality care outcomes and cost effective transitions. 




The CM Supervisor is a subject matter expert who ensures prompt and complete clinical information is submitted to payers for initial and continued certification consistent with the use of standards of patient care and nursing practices, actively works to mitigate both concurrent and post-discharge denial risks and is actively involved with the appeals processes. 




The CM Supervisor provides real-time information on current patient status and needs to ensure proper progression through the healthcare system, issuing updates on a daily basis so that all team members are aware of patient needs. 




The CM Supervisor adheres to the organization’s Code of Ethics and Corporate Compliance Program, and complies with all relevant policies, procedures, guidelines and all other regulatory and accreditation standards.



Required Qualifications :

Job Requirements




Required Licenses




[Wyoming, United States] Registered Nurse
Current WY RN license or compact equivalent


Case Management Certification preferred


Must attend education programs to maintain required CE hours for active credentials


BLS certification must be obtained within 90 days of employment from an approved American Heart Association training center


 


Minimum Education


 


RN required, BSN preferred. May be an RN with BS in health related field.


 


Minimum Work Experience




3 to 5 years’ experience in acute care, case management or related experience preferred.


Proficient in the application of InterQual criteria preferred.


 


Required Skills




Hands-on experience utilizing computer programs (Microsoft Word, Excel, Microsoft Outlook, Medhost and/or MorCare preferred).


Must possess excellent documentation skills along with written and verbal communication skills. Excellent critical thinking skills, negotiating skills, ability to prioritize and multi-task necessary. Proven leadership and diplomacy skills to affect positive case management outcomes.


Skilled in coaching and conflict management to maximize the achievement of case management outcomes.


Near visual acuity for close paperwork; and good motor coordination required to operate photocopier, CRT and computer.


Good hearing essential to operate telephone and assist physicians, office personnel and the public



 


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