18 days old

Case Management Supervisor Full Time Days

AdventHealth
Tarpon Springs, FL 34689
  • Job Code
    9006_20025358

Description

"Case Management Supervisor Full Time DaysAdventHealth Tampa

Location Address:3100 East Fletcher Avenue Tampa, Florida 33613

Top Reasons to Work at AdventHealth Tampa

  • Florida Hospital Pepin Heart Institute, known across the country for its advances in cardiovascular disease prevention, diagnosis, treatment and research.
  • Surgical Pioneers the first in Tampa with the latest robotics in spine surgery
  • Building a brand new, six story surgical and patient care tower which will ensure state of the art medical and surgical car for generations to come
  • Awarded the Get With The Guidelines Stroke GOLD Quality Achievement Award from the American Heart Association/American Stroke Association and have been recognized as a recipient of their Target: Stroke Honor Roll for our expertise in stroke care. We have also received certification by The Joint Commission in collaboration with the American Stroke Association as a Primary Stroke Center.
Work Hours/Shift:
Full Time days

RINCIPAL DUTIES AND JOB RESPONSIBILITIES:

  • As a member of the care coordination leadership team, performs various supervisory functions to include; daily supervision of staff, daily staffing, monitors work schedules and productivity, goal monitoring, assist with personnel performance improvement activities, assists in the hiring process, collaborates with director regarding performance evaluations and scorecard completion
  • Provides assistance to the Director in the daily work flow and clinical supervision of Case Managers to include ensuring effective AM/PM Ninja Huddles occur between DCP and CN, MDRs are effective and efficient with proper documentation, complex cases are appropriately managed with updates given to Complex Case Committee, daily huddles with team members to ensure LOS is properly managed and Medicare CoPs are properly addressed to include IMM, IA, Choice, MOON, and ABNs
  • Evaluates processes relative to meeting regulatory and compliance standards; makes recommendations as appropriate to ensure that work practices are meeting such standards
  • Assures the Utilization Management Plan is followed
  • Conducts initial and annual competency assessments of staff and provides ongoing monitoring of competency in a setting of rapidly changing requirements and regulations
  • Develops orientation and educational material and tools for the case management staff
  • Provides training and education as needed to maintain competency of Case management staff.
  • Conducts audits, analyzes reports, populate scorecards of staff performance and activity; provides feedback to staff and assists in development of action plans to improve performance
  • Recognizes new challenges effecting the department, assists in developing a nimble response and orchestrates the activities of the team to assure success
  • Participates in department-based Performance Improvement activities
  • Displays a high level of flexibility, adaptability and organization skills in response to the caseload; effectively prioritize workload
  • Accepts special projects as assigned
  • Communicates effectively and proactively with management on any matters of concern or risk
  • Recognizes new challenges effecting the department, assists in developing a nimble response and orchestrates the activities of the team to assure success
  • Demonstrates knowledge and adherence to regulatory guidelines and requirements for care coordination management as indicated by hospital corporate compliance plan, local, state, and federal agencies and accrediting bodies: e.g. TJC, CMS, QIO, DNV, AHCA
  • Attends educational offerings as needed to promote continuous learning and support to department
  • Provides input into the revisions in the Utilization Management Plan
  • Guides and conducts rounds or huddles related to appropriate level of service (inpatient, outpatient, outpatient /bed and observation), focusing on minimizing system barriers to timely and safe patient discharges to the next appropriate level of care
  • Maintains knowledge of and medical necessity criteria- initial, concurrent and discharge
  • Responsible for educating staff regarding utilization management related denials, audits, and appeals for governmental and commercial payors including identifying need for review of potential changes in status in order to avoid 12x claims through implementing a CC44 and need to flip OP to IP status as OBS cross to second MN
  • Collaborates with other departments and division in order to facilitate the revenue cycle process related to utilization management, change in status, denials, audits, and appeals
  • Identifies process improvements and educates Case Managers, Social Workers, physicians and other department personnel (e.g. Nursing, HIM, Patient Access, and PFS) regarding findings and documentation improvement strategies to reduce or avoid denials

Qualifications
Qualifications:
  • Bachelors Degree in Nursing or Masters Social Worker (MSW)
  • Minimum of 1 Year of Position-Related Experience
  • Minimum of 3 years of Acute Care setting case management experience
  • Excellent interpersonal skills, oral and written communication skills required
  • PC application familiarity (i.e., electronic medical record documentation, Word Processing, spreadsheet interpretation)
  • Ability to develop agenda and conduct meetings
  • Ability to present and/or educate in both small and large group
  • Knowledge and Application of Evidence Based Criteria
  • Knowledge and Application of Regulatory Agency Requirements
  • Florida Registered Nurse License and/or MSW with ACMA certification
PREFERRED:
  • 3+ Years of Position-Related Experience
  • ACMA certified
  • Licensed Case Manager
Job Summary:

The Case Management Supervisor is responsible for the day-to-day supervision of case management and staff, in the Care Coordination Department, including assistance with staff assignments and assists the Administrative Director in meeting strategic goals of the department. The Supervisor manages the processes related to proactive discharge planning and utilization management functions. Serves as a Case Management subject matter resource and incorporates knowledge of hospital policies, procedures, protocols, state and federal regulations into decision making.

This facility is an equal opportunity employer and complies with federal, state and local anti-discrimination laws, regulations and ordinances.





Posted: 2020-11-09 Expires: 2020-12-08
Sponsored by:
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Sponsored by:
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Case Management Supervisor Full Time Days

AdventHealth
Tarpon Springs, FL 34689

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