(Archived) AIS - Nurse Case Manager Supervisor

JOB SUMMARY:

Monitors the activity of the case management staff for timeliness with regulatory compliance and provides clinical support and assistance as needed. Provide direction with problem identification, problem solving and development of new processes for the staff.

MAJOR DUTIES AND RESPONSIBILITIES:

• Provides directsupervision and training and assures coverage of the telephonic nurse casemanagers and administrative staff.
• Oversee thedistribution of new case referrals.
• Oversees anddrives to departmental goals in timely and appropriate handling of pre-certificationprocessing, file handling, IME referrals, appropriate closures and optimal customer service.
• Interacts with medicalproviders and patients on claim inquiries.
• Interfaces withaccount representatives to insure open line of communication regarding casemanagement processes.
• Responsible for stafftime, attendance and approval of scheduled time off.
• Responsible toconduct performance evaluations of staff.
• Providedirection with problem identification, problem solving, and development ofnew processes as needed.
• QualityAssurance calibration, best practice to direct staff performance.
• Assurancescompliance with State regulatory statutes and Medical Standards.
• Assures casemanagement services are provided with in CSMA Standards of Care.
• Provide daily statisticson staff production.
• Assess thelearning needs of the case management staff and facilitate training with Nurse Educator and/or training department.
• Ensure smoothworkflow processes among the case management staff and all AIS departments.
• Oversee theapplication of client plans and AICRA.

JOB-RELATED SKILLS:

• Strong problemsolving, critical thinking and interpersonal skills.
• Excellentwritten and verbal communication skills, including conflict management
• Knowledge ofcomputers, Word and Window NT, Excel