Supervisor, Care Management, Utilization Review

Description Our team members are the heart of what makes us better. At Hackensack Meridian Health we help our patients live better, healthier lives — and we help one another to succeed. With a culture rooted in connection and collaboration, our employees are team members. Here, competitive benefits are just the beginning. It’s also about how we support one another and how we show up for our community. Together, we keep getting better — advancing our mission to transform healthcare and serve as a leader of positive change. The role integrates and coordinates utilization management, care coordination, discharge planning functions and performance improvement activities for all care managers. The Supervisor, Care Management is accountable for oversight of the department's designated team member caseloads and plans effectively in order to meet staffing needs, manage length of stay, promote efficient utilization of resources and ensure that care meets evidence-based practice standards and regulatory/payor requirements. Responsibilities Facilitates collaborative management of patient care across the continuum, intervening as necessary to remove barriers to timely and efficient care delivery and reimbursement. Supervises the staff with all care management processes, including LOS, throughput, patient flow and denials and appeals follow up. Applies process improvement methodologies in evaluating team member's documentation. Ensures that multidisciplinary rounds and team huddles are occurring. Provides direction to the multidisciplinary team as needed in difficult cases. Obtains, interprets and presents metrics related to care management. Attends key meetings and presents the information about existing case management processes. Develops the performance improvement plan of the care manager, documents performance and provides performance feedback, evaluates the work of the team member and provides reward and recognition for proper and efficient performance. Determines areas of opportunities and suggest process improvement. Follows HR policies for performance and disciplinary action. Responsible for disciplinary action and performance improvement plans when appropriate. Participates in departmental preparation for regulatory visits and compliance audits. Coordinates/facilitates patient care progression throughout the continuum by working collaboratively with the multidisciplinary team. Collaborates with ancillary departments to ensure accuracy of patient demographic and insurance information. Assists in the collection and reporting of indicators tracking efficiency of case management processes. Uses data to drive decisions and plan/implement performance improvement strategies related to assigned staff, including fiscal, clinical, and patient satisfaction data. Collaborates with Physician Advisors, Hospitalist in needs related to Case Management and difficult cases. Maintains annual competencies and ensures training and continuing education of the team in applicable platforms (Epic, Xsolis Cortex, BI, Google Suites). Assumes responsibility for supervision of other case management care coordination managers in the absence of a Supervisor. Other duties and/or projects as assigned. Adheres to HMH Organizational competencies and standards of behavior. Qualifications Education, Knowledge, Skills and Abilities Required: Bachelor's degree, Nursing or Master's Degree in Social Work. At least 3 years full time experience in an acute care setting. Familiar with hospital resources, community resources, and/or resource/utilization management. Care coordination, case management or discharge planning experience. Effective decision-making/problem-solving skills, demonstration of creativity in problem-solving, and influential leadership skills. Excellent verbal, written and presentation skills. Moderate to expert computer skills. Excellent written and verbal communication skills. Proficient computer skills that may include but are not limited to Microsoft Office and/or Google Suite platforms. Education, Knowledge, Skills and Abilities Preferred: Not applicable. Licenses And Certifications Required Registered Nurse (RN) with current New Jersey (NJ) License, or Licensed Social Worker (LSW) or Licensed Clinical Social Worker (LCSW). Case Management certification by a nationally recognized organization within 1 year. Licenses And Certifications Preferred Basic Cardiac Life Support Certificate. HMH is committed to pay equity and transparency for our team members. The posted rate of pay in this job posting is a reasonable good faith estimate of the minimum base pay for this role at the time of posting in accordance with the New Jersey Pay Transparency Act and does not reflect the full value of our market-competitive total rewards package. Job Duties The starting rate of pay is provided for informational purposes only and is not a guarantee of a specific offer. Posted hourly rates may be stated as an annual salary in the offer and posted annual salaries may be stated as an hourly rate in the offer, depending on the level and nature of the job duties and credentials of the candidate. The base compensation determined at the time of the offer may be different than the posted rate of pay based on a number of non-discriminatory factors, including but not limited to: Labor Market Data: Compensation is benchmarked against market data to ensure competitiveness. Experience: Years of relevant work experience. Education and Certifications: Level of education attained, including specialized certifications, credentials, completed apprenticeship programs or advanced training. Skills: Demonstrated proficiency in relevant skills and competencies. Geographic Location: Cost of living and market rates for the specific location. Internal Equity: Compensation is determined in a manner consistent with compensation ranges for similar roles within the organization. Budget and Grant Funding: Departmental budgets and any grant funding associated with the job position may impact the pay that can be offered. Some jobs may also be eligible for performance-based incentives, bonuses, or commissions not reflected in the starting rate. Certain positions may also be eligible for shift differentials for work performed on evening, night, or weekend shifts. In addition to our compensation for full-time and part-time (20+ hours/week) job positions, HMH offers a comprehensive benefits package, including health, dental, vision, paid leave, tuition reimbursement, and retirement benefits. Minimum rate of $107,952.00 Annually #J-18808-Ljbffr Hackensack Meridian Health