Supervisor, Case Management (Outpatient)
Location: Orange, California US
Job Number: 2160
Position Title: Supervisor, Case Management
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 outpatient 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:
- Mentor, train, audit, coach and manage a team of RN Case Managers to ensure compliance with Alignment policies and procedure and all regulatory requirements.
- Always maintains a state of “audit readiness” by coordinating chart auditing activities; monitors CM processes and reports outcomes to the CM Director.
- Assumes a proactive role in problem-solving CM issues
- Assists with assessments and the development and implementation of action plans and project outcomes.
- Trains new CM staff and coaches’ current staff.
- 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.
- Remains current on relevant CM topics and shares information with other CM nurses.
- Collaborates with the Alignment Health Plan Medical Director, Quality Management Director and Compliance Director as required.
- Performs daily Case Management when required and handles escalated
- Ensures that all staff are documenting according to internal processes as outlined in Department policies, protocols, and standard operating procedures.
- Collects, evaluates, and reports clinical, functional and CM program activity to the CM Director.
- Assists with the review and development of new protocols, procedures, and guidelines.
- Maintains confidentiality of information between and among health care professionals.
- Other duties as requested or assigned.
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.
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.
- 5 + years of RN Case Management experience; or any combination of education and experience, which would provide an equivalent background.
- 1 + years supervisory/lead experience in a health care setting.
- Current, Active and Unrestricted California Registered Nursing license
- CCM preferred
- BSN required/ Masters preferred
- Knowledge of Medicare Managed Care Plans
- Demonstrated leadership skills
- Ability to manage projects/initiatives to improve program performance
- Ability to organize, prioritize and delegate workflow
- Ability to apply program guidelines and follow procedures
- 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.
- 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.
- 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 firstname.lastname@example.org.
Location City: Orange
Location State: California
Community / Marketing Title: Supervisor, Case Management (Outpatient)
Who is Alignment Healthcare?
- Socially responsible
- Technologically enabled
- Concierge care
- Servant leadership
We are dedicated to transforming the complex and confusing process of medical treatment in the United States so that every link in the health care continuum becomes more efficient, productive, and effective. We built a team of people who want to make a difference. Come join the team that is changing health care one person at a time.
We believe that great work comes from people who are inspired to be their best. We invite you to explore our wide variety of roles based on your unique experience.