Care Management Supervisor

PruittHealth•Norcross, GA

About The Position

The Care Management Supervisor is responsible for assisting in the oversight and day-to-day activities of the Care Management Department Care Management Assistants. This role involves delegating responsibilities and ensuring assigned duties are carried out effectively. The position also focuses on implementing partner relations practices to foster a positive environment and high partner morale, participating in recruitment and orientation, and serving as a liaison between vendors and customers. A key aspect is developing an in-service schedule to ensure staff skills are up-to-date for quality care, performing routine chart audits, and handling customer complaints. The supervisor must maintain the privacy and confidentiality of protected health information and facilitate clear communication among departments. They are expected to keep their supervisor informed of daily activities, propose solutions to issues, and maintain effective working relationships with colleagues and management. Exceptional customer service is paramount, and the role may involve managing a small caseload. Timely attendance and participation in professional training are also required.

Requirements

Knowledge of commercial insurance is fundamental.
Knowledge of the Fundamentals of Case Management.
Ability to communicate effectively with payers, clients and providers essential.
Must have working knowledge of computers, including Microsoft office programs.
Understanding of state and federal regulations crucial.
3-5 years experience preferable in a commercial managed care or case management organization or post acute provider environment.
Equivalent combination of experience and training which provides the required knowledge, skills, and abilities.

Nice To Haves

BSN preferred
Experience in a commercial managed care or case management organization or post acute provider environment

Responsibilities

Implements partner relations practices necessary to establish a positive partner relationship and promote a high level of partner morale.
Responsible for recruitment and employment of Care Management Assistant staff, ensuring that they have the necessary qualifications to perform their job descriptions.
Participates in the development and implementation of an orientation program for each partner.
Serves as the liaison between Commercial contracted vendor and our customers.
Responsible for developing an in-service schedule for the Care Management Assistant staff that ensures that members of the department have skills necessary to ensure quality care.
Performs routine chart audits to ensure quality case management.
Provides back-up coverage.
Handles customer complaints expeditiously and according to policy.
Ensure that Care Management Assistant staff is meeting company standards of customer service.
Maintains the privacy and confidentiality of protected health information, as well as sensitive information pertaining to other partners of PruittHealth.
Facilitates clear information passage within and among departments involved.
Keeps supervisor informed of daily activities and issues. Purposes solutions to all issues.
Must get along with co-workers; maintain effective relationships with management staff, partners and the general public.
Must deliver exceptional customer service at all times.
May be responsible for a small caseload.
Performs other roles, administrative tasks and related duties as required by supervisor.
Must have timely, regular attendance.
Attend professional training as directed.