Supervisor, Case Management

Medica•Minnetonka, MN

1d•Hybrid

About The Position

This position is accountable for the day to day operational support and strategic activities of the assigned team. This position is also accountable for achieving department objectives and maintaining flexibility to meet business needs. Responsibilities include supervision of the clinical team members, ensuring that the strategic and business processes are established, maintained and communicated, and effective interdepartmental communications are established. Participate in planning, implementation and evaluation of the case management program to ensure quality services and compliance with all regulatory and contractual requirements. This position resides in the Health Services department, yet interacts regularly with other areas within Medica. In addition to the coaching and staff development responsibilities, the Supervisor must also build strong relationships with internal and external partners. More specifically, support the Director or Manager, case management in relationship building within Medica and its vendor partners to help prioritize, integrate and coordinate interventions for population segments based on medical, behavioral and social needs. This role oversees case management projects, initiates and participates in quality improvement activities, and performs data monitoring of utilization activity for reporting to internal customers. Performs other duties as assigned.

Requirements

Associate's or Bachelor's degree in Nursing
5+ years of related work experience beyond degree, plus 1+ years leadership experience
Active, unrestricted RN License in the state of MN required
Certified Case Manager (CCM) preferred or the ability and commitment to obtain within two years of hire

Nice To Haves

Experience working with vulnerable and complex populations in a clinical, home care or telephonic environment; direct case management experience strongly preferred.
Experience and at ease working with various populations: multiple age groups, ethnic and socioeconomic backgrounds, medical, surgical backgrounds and a generalized level of understanding across specialty care areas.
Experience managing multiple computer systems and tools.
Proven experience in case management, healthcare operations, or a related field.
Strong leadership, coaching, and team development skills.

Responsibilities

Supervise and Maintain Efficient Department Operational Systems/Process
Comply with policy and procedures effectively and with appropriate documentation and ensure team meets all department, regulatory and contractual requirements and goals.
Informs the Manager/Director of process, procedure, policy and other issues that cannot be resolved within the team.
Model change management philosophies and support and facilitate a positive approach to change among team members.
Monitor team members’ calls and casework to ensure staff is following department guidelines, processes and turn-around times.
Manage performance and hold staff accountable for meeting department standards for quality, turn around times, policy application, effectiveness, attendance, and personnel management, etc.
Formulate action plan for less than acceptable performance.
Consult Human Resources and Manager/Director to ensure compliance with company policies and values.
Responsible for personnel management including interview process, goals establishment, performance review, and team-building.
Assist with delivery of new employee orientation programs for team members, and contributes to the development, maintenance and communication of educational programs as indicated.
Compile and report team and individual statistics for planning and evaluation.
Assist the Manager and Director to define and utilize performance standard to monitor staff performance.
Accountable for driving performance toward goals and communicating effectively to peers when process gaps are impeding goals.
Manage Performance of Case Management Team Leads and supervises the program and team as outlined under the Position Overview section.
Ensures that the case managers successfully meet and exceed process-oriented outcomes.
Assess the training and development needs of each new employee to result in fully competent performance within one year.
Assess existing employees for training and development needs or performance improvement plans.
Provide team members with ongoing and consistent feedback, directed toward clinical excellence and accountability to department goals.
Regularly assess and measure team workload and staffing ratios, ensure workload is evenly distributed.
Develop and implement plan for backlog situations when needed.
Coach, encourage and facilitate individual growth and development through specific, timely and consistent feedback.
Conduct regular and timely one on one meeting.
Ensure timeliness and accuracy of all required administrative functions, i.e. timecards, performance evaluations, call recordings, expense reports, etc.
Communicate management decisions in a positive manner to staff.
Accessible during workday to facilitate problem solving and resolution of case review issues and complaints.
Take phone calls, handle escalated issues, and provide a setting for clinical case consultations.
Provide technical and clinical support to staff by researching and responding to their questions.
Coach staff on the Quality Audit results. Recommendations from audits are evaluated and appropriate improvement measures are taken.
Work closely with project management team on implementation of new and renewing clients and for new and ongoing company and department initiatives.
Exhibit skills in organization, project management, time management, and meeting facilitation.
Assist in the development, implementation or maintenance of department programs, which reflect quality of service and care as delegated by the manager/director.
Represent the case management program at interdepartmental meetings and committees.
Establish and Maintain Positive Relationships with Internal and External Customers
Assist in developing and maintaining strong, positive and open relationships with other internal and external stakeholders.
Listen to and understand customer’s questions, concerns or problems.