Registered Nurse - Case Management Supervisor (Utilization Management)
Cedars-Sinai Medical Center
Location: Los Angeles, California
Internal Number: HRC0652982
Are you ready to bring your expert clinical skills to a world-class facility recognized as one of the top ten in the United States? Do you have a passion for the highest quality and patient happiness? Then please respond to this dynamic opportunity available with one of the best places to work in Southern California! We would be happy to hear from you.
As a Case Management Supervisor, you will work in collaboration with the department leadership to provide hands-on advice to help implement Case Management department strategies and provide oversight of daily department operation. This position utilizes case management knowledge and skills to ensure the right care, at the right time and the right place, for every patient. You will use your excellent analytical, organizational, oral and written, and interpersonal communications skills, ability to manage multiple tasks and priorities to independently resolve complex issues and keep management appropriately informed.
Summary of Essential Duties:
Facilitates the daily operations of the department and acts as a liaison with interdepartmental communication
Responsible for staff scheduling; monitoring of time and attendance compliance; arrange and adjust contingency schedules for vacations, unscheduled days off, staffing crises
Handle administrative duties, including disciplinary process and performance improvement plans; resolve or facilitate resolution of problematic and/or complex issues by calling out to appropriate management/leadership person
Demonstrate knowledge of and ensure knowledge of staff regarding medical necessity, regulatory requirements and standards, i.e. Joint Commission, Title 9, CMS/Medicare guidelines, EMTALA, HIPAA, etc.
Serves as a Subject Matter Expert (SME) for department workflow issues, complex cases and handles advanced clinical issues from the staff
Audits for documentation, compliance with department metrics, regulatory compliance and application usage; and managing projects as assigned
Provides coaching and counseling to improve productivity of staff members
Recruit, staff orientation, training and precepting; training of new applications or updates; creates educational material for staff members to improve skills, aid in professional growth and development and to ensure staff's expertise
Participates in process reviews and the development of new and/or revised work processes, policies and procedures
Communicates and supports change within the department. Creates and supports an environment that fosters teamwork, cooperation, respect, and diversity
Current, unrestricted California RN License required
Certified Case Manager or Case Management Certification (ACMA or CCM) preferred
BLS from the American Heart Association or American Red Cross required
A minimum of 3 years of acute care inpatient Utilization Management experience required
Previous supervisor or leadership experience preferred
Proficiency in MS Office required
Experience using Milliman or Interqual preferred
Keywords: Registered Nurse, RN, Case Manager, Case Management, Utilization, Supervisor, Hospital, Medical Center, Los Angeles, CA, California
Working Title: Registered Nurse - Case Management Supervisor (Utilization Management)
Providing healthcare for more than 100 years, Cedars-Sinai has evolved into one of the most dynamic and highly renowned medical centers in the world. Along with caring for patients, Cedars-Sinai is a hub for biomedical research and a training center for future physicians and other healthcare professionals. This attracts exceptional talent to Cedars-Sinai, including world-renowned physician-scientists who seek a place where they can both conduct research and see patients--the ideal formula for discovery and its translation into cures. Our patients benefit from access to doctors at the top of their fields, and our researchers have an ideal community in which to study the impact of healthcare challenges, and reflect that knowledge in their research. The greater Los Angeles area in which Cedars-Sinai resides possesses unparalleled cultural and ethnic diversity which offers outstanding opportunities for translational and clinical research and a dynamic environment for medical education.Although community based, Cedars-Sinai is a major t...eaching hospital affiliated with the David Geffen School of Medicine at the University of California, Los Angeles (UCLA). Cedars-Sinai has highly competitive graduate medical education programs in more than 50 specialty and subspecialty areas, a graduate program in biomedical sciences and translational medicine, a clinical scholars program directed towards junior physicians with aspirations to become clinical scientists, and post graduate training opportunities.There are more than 250 full-time faculty members at Cedars-Sinai. The voluntary medical staff, comprised of more than 2,200 specialty board-certified or board-qualified physicians, represent all of the specialties and subspecialties and collaborate with full-time medical staff in the teaching responsibilities of the graduate medical education programs.
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