Registered Nurse - Case Management Supervisor (Utilization Management)
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
- BSN required
- 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)
- Department: Utilization Management
- Business Entity: Corporate Services
- City: Los Angeles
- Job Category: Patient Services, Nursing, Nursing - Experienced Nurses
- Job Specialty: Case Management
- Position Type: Full-time
- Shift Length: 8 hour shift
- Shift Type: Day
- Recruiter: Leila Harris
Cedars-Sinai is an EEO employer and does not unlawfully discriminate on the basis of race, religion, origin, citizenship, ancestry, disability, legally protected medical condition, marital status, sex, sexual orientation, gender identity, gender expression, age (40 or older), military and/or veteran status or any other basis protected by federal or state law. We will consider for employment qualified applicants with criminal histories, in accordance with the Los Angeles Fair Chance Initiative for Hiring.
As an employee, you can apply to this internal job posting.