Sentara Norfolk General Hospital is hiring a Supervisor, MSW, Inpatient Case Management. This is a full-time 40 hour per week position. The Supervisor, MSW, Inpatient Case Management assumes responsibility, accountability and leadership for the daily operations including coordination of work, quality, and service. This is a first-line supervisor position in the Utilization Management Department. The role facilitates the work of assigned team members and provides a leadership role in ongoing utilization review competency assessment, needs identification and educational offerings. The Supervisor also provides educational services to the Utilization Management staff and participates in the work activities of assigned teams. Responsibilities include the review of clinical information received from providers, ensuring clinical data is substantial enough to meet Medical Necessity Criteria to authorize services as needed. Requires knowledge of managed care contracting, Medical Necessity, CMHRS services, DMAS protocols, clinical protocols and clinical review requirements. Requires knowledge of contractual, regulatory and compliance requirements for government payers, self-funded and commercial payers. Ensures appropriate and accurate information is entered into claims system for processing of payment.
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Job Type
Full-time
Career Level
Manager