Supervisor, Case Management (SNP)

Location: Orange, California US

Notice

This position is no longer open.

Job Number: 2159

Workplace Type:

Position Title: Supervisor, Case Management

External Description:

The Supervisor, Case Management demonstrates competency in the concepts, principles, strategies, and application of CM practices. The Supervisor position is responsible for: 1) day-to-day SNP case management activities, 2) direct supervision of licensed and coordinator staff, and 3) promotion of quality care outcomes while supporting appropriate utilization and resource management along the continuum of care.

Essential Duties and Responsibilities:

Essential duties and responsibilities include, but are not limited to:

  1. Mentor, train, audit, coach and manage a team of RN Case Managers to ensure compliance with Alignment policies and procedure and all regulatory requirements.
  2. Always maintains a state of “audit readiness” by coordinating chart auditing activities; monitors CM processes and reports outcomes to the CM Director.
  3. Assumes a proactive role in problem-solving CM issues
  4. Assists with assessments and the development and implementation of action plans and project outcomes.
  5. Trains new CM staff and coaches’ current staff.
  6. Assigns and provides daily oversight of the activities and tasks of the CM team including Case Management referrals, transitions of care and coordination of care.
  7. Remains current on relevant CM topics and shares information with other CM nurses.
  8. Collaborates with the Alignment Health Plan Medical Director, Quality Management Director and Compliance Director as required.
  9. Performs daily Case Management when required and handles escalated cases.

    10. Ensures that all staff are documenting according to internal processes as              outlined in Department policies, protocols, and standard operating procedures.

  1. Collects, evaluates, and reports clinical, functional and CM program activity to the CM Director.
  2. Assists with the review and development of new protocols, procedures, and guidelines.
  3. Maintains confidentiality of information between and among health care professionals.
  4. Other duties as requested or assigned.

Supervisory Responsibilities:

Oversees assigned staff. Responsibilities include recruiting, selecting, orienting, and training employees; assigning workload; planning, monitoring, and appraising job results; and coaching, counseling, and disciplining employees.

Minimum Requirements

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required.

  1. Minimum Experience:
  2. 5 + years of RN Case Management experience; or any combination of education and experience, which would provide an equivalent background.
  3. 1 + years supervisory/lead experience in a health care setting.
  4. Education/Licensure:
  5. Current, Active and Unrestricted California Registered Nursing license
  6. CCM preferred
  7. BSN required/ Masters preferred
  8. Other:
  9. Knowledge of Medicare Managed Care Plans
  10. Demonstrated leadership skills
  11. Ability to manage projects/initiatives to improve program performance
  12. Ability to organize, prioritize and delegate workflow
  13. Ability to apply program guidelines and follow procedures
  14. Computer Skills: Word, Excel, Microsoft Outlook

Essential Physical Functions:

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

  1. While performing the duties of this job, the employee is regularly required to talk or hear. The employee regularly is required to stand, walk, sit, use hand to finger, handle or feel objects, tools, or controls; and reach with hands and arms.
  2. The employee may lift and/or move up to 10 pounds. Specific vision abilities required by this job include close vision and the ability to adjust focus.

Alignment Healthcare, LLC is proud to practice Equal Employment Opportunity and Affirmative Action. We are looking for diversity in qualified candidates for employment: Minority/Female/Disable/Protected Veteran. 

If you require any reasonable accommodation under the Americans with Disabilities Act (ADA) in completing the online application, interviewing, completing any pre-employment testing or otherwise participating in the employee selection process, please contact [email protected].

City: Orange

State: California

Location City: Orange

Location State: California

Community / Marketing Title: Supervisor, Case Management (SNP)

Company Profile:

By leveraging our world-class technology platform, innovative care delivery models, deep physician partnerships and our serving heart culture, Alignment Health is revolutionizing health care for seniors! From member experience professionals and clinicians, to data scientists and operations leaders, we have built a talented and passionate team that is deeply committed to our mission of transforming health care for the seniors we serve. Ready to join us?

At Alignment, delivering exceptional care to seniors starts with ensuring an exceptional experience for our over 1,300 employees. At the center of our employee experience is a culture where employees at all levels and across all teams are encouraged to share their unique ideas and perspectives. After all, when you can bring your authentic self to work, whether that’s in a clinical setting, our corporate office or a home office, creativity and innovation flourish! Another important part of the Alignment culture is a belief in continuous learning and growth. As a result, in this fast-growing company, you will find ample support to grow your skills and your career – with us.

EEO Employer Verbiage:

 

Please note: All clinical positions are contingent upon successful engagement with Alignment Health’s COVID-19 Vaccination program (fully vaccinated with documented proof or approved exception/deferral).

Alignment Health is an Equal Opportunity/Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, age, protected veteran status, gender identity, or sexual orientation.

*DISCLAIMER: Please beware of recruitment phishing scams affecting Alignment Health and other employers where individuals receive fraudulent employment-related offers in exchange for money or other sensitive personal information. Please be advised that Alignment Health and its subsidiaries will never ask you for a credit card, send you a check, or ask you for any type of payment as part of consideration for employment with our company. If you feel that you have been the victim of a scam such as this, please report the incident to the Federal Trade Commission at https://reportfraud.ftc.gov/#/. If you would like to verify the legitimacy of an email sent by or on behalf of Alignment Health’s talent acquisition team, please email [email protected].