Case Management Supervisor - Full Time - Days

Mohawk Valley Health System•City of Utica, NY

2d•$81,000 - $131,000

About The Position

The Case Management Supervisor oversees case management staff responsible for authorization, coordination, utilization, and provision of member services. The role supervises and mentors staff to support quality, efficient, and comprehensive care for a diverse member population. It also provides direct oversight of daily utilization review operations, processes, and procedures to ensure member care needs are accurately met and documented in accordance with managed long term care (MLTC) insurance regulations.

Requirements

New York State licensed Registered Nurse with a bachelor's degree in nursing or a health-related field, or a New York State licensed Social Worker.
If a Registered Nurse, at least 1 year of medical-surgical experience.
3–5 years of Case Management experience.
Prior supervisory experience.
Current New York State license and registration to practice as a Registered Nurse, or current New York State license and registration to practice as a Licensed Clinical Social Worker.
Valid New York State driver's license.

Responsibilities

Coordinate daily work within the Case Management function, distribute assignments, and monitor work for quality and completeness.
Ensure the Case Management team works effectively and efficiently with the interdisciplinary health care team to meet patient, departmental, and organizational goals.
Provide education and training to support the day-to-day operation of the Case Management department.
Help identify over-utilization of services and report trends to Case Management leadership.
Ensure the Case Management team follows Conditions of Participation and regulatory requirements affecting patient rights.
Participate in quality improvement initiatives, continuing education, system-wide and unit-specific teams, and efforts to improve nursing practice and safe outcomes.
Maintain cooperative relationships across the health care team through communication, responding to requests, rapport-building, and team problem-solving.
Provide empathetic, compassionate, patient-centered service to patients and their families or visitors; address concerns using positive service recovery methods, respond to requests, make referrals to appropriate decision-makers, and provide culturally sensitive care.
With leadership and Human Resources guidance, provide input or recommendations regarding employee hires, performance reviews, transfers, promotions, salary changes, disciplinary actions, terminations, and similar matters.
Resolve grievances and staff problems fairly, promptly, and consistently, in conjunction with Human Resources.
If working as a Registered Nurse, practice in accordance with the New York State Practice Act and applicable regulatory standards.
Ensure understanding of and compliance with MVHS policies, procedures, and regulations.
Perform related duties as assigned.