Supervisor, Large Case Management

Lucent Health Solutions LLC • Nashville, TN

8d

About The Position

The Supervisor of Large Case Management is responsible for the daily support and operational performance of the Large Case Management (LCM) team. This role ensures effective case management of high-cost and complex medical cases, promotes quality member outcomes, and maintains compliance with regulatory and contractual requirements. The Supervisor provides leadership, coaching, and clinical support to case management staff while coordinating with internal departments and external vendor partners to optimize case outcomes and financial impact.  Additionally, the Supervisor supports case management vendor referrals and oversight.  The Supervisor reports to the Manager, LCM.  This role may require some intermittent travel.

Requirements

• Registered Nurse with a minimum of 5 years of recent clinical nursing experience.
• Minimum of 1 year in a healthcare leadership role (e.g. team lead or higher)
• Bachelor’s Degree from an accredited college or university required
• Demonstrated ability to manage and lead a team of direct reports
• Excellent written and oral communication skills
• Strong analytical skills with attention to detail
• Ability to identify areas of improvement and develop action plan to address findings
• Positive, proactive team-oriented approach/attitude
• Strong knowledge of Microsoft Office products
• Holds a current, active, and unrestricted RN license that allows him/her to practice in a state or territory of the United States.

Nice To Haves

• Relevant certifications such as Certified Case Manager (CCM) may be preferred.

Responsibilities

• Supervise day-to-day operations of the Large Case Management team, including monitoring productivity, case volumes, timeliness, and quality of documentation.
• Provide guidance, coaching, and performance feedback to case managers and support staff.
• Support Case Management vendor referrals, including clinical review to determine appropriateness of referrals to vendors
• Support preparation, accuracy, and timeliness of monthly and ad hoc stop loss reports, ensuring data integrity and clinical relevance for high-cost claims.
• Ensure all case management activities meet accreditation, regulatory, and contractual standards (e.g., state, federal, URAC, NCQA, HIPAA).
• Support internal and external audits, quality assurance initiatives, and process improvement efforts.
• Communicate effectively with leadership on case management outcomes, trends, and opportunities for improvement.
• Reviews referrals to case management and completes daily assignments
• Maintains licensure spreadsheet and ensures adequate state coverage based on new clients onboarding
• Collaborates with case management team to resolve complex care member issues
• Maintains knowledge of regulations, accreditation standards, and industry best practices related to case management
• Works with case management team and senior management to identify opportunities for process and quality improvements within case management.
• Educates and provides resources for case management team on key initiatives and to facilitate on-going communication between case management team
• Works with the senior management to develop and implement case management policies, procedures, and guidelines that ensure appropriate and effective utilization of healthcare services
• Evaluates case management team performance and provides feedback regarding performance, goals, and career milestones
• Provides coaching and guidance to case management team to ensure adherence to quality and performance standards
• Assists with onboarding, hiring, and training case management team members as needed
• Leads and champions change within scope of responsibility
• Performs other duties as assigned

What This Job Offers

• Job Type: Full-time
• Career Level: Manager