Supervisor Of Case Management
Holly Hill, FL 
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Posted 15 days ago
Job Description
Supervisor Of Case Management
Florida Health Care Plans
Full-time
Monday - Friday 8am - 5pm
POSITION SUMMARY:

The Supervisor of Case Management is responsible for promoting high-quality, cost-effective care to optimize the wellbeing of our members. They are responsible for the overall day-to-day management of the case management program including coordination, supervision and administrative oversight of the case management team. Engaging with hard-to-reach members may involve travel to hospitals, rehab or skilled nursing facilities or member's homes, to evaluate their needs face-to-face. The supervisor will collaborate closely with external vendors, as well as internal multidisciplinary team members, to provide case management services to FHCP members.

QUALIFICATIONS:
Education, skills and experience:

  • Current and unencumbered licensure in Florida as a Registered Nurse.

  • Minimum of 3 years leadership experience required, preferably in Case Management or Utilization Management.

  • Minimum of 5 years clinical experience required. Acceptable areas include Ambulatory Care, Medical/Surgical, Pediatrics, Skilled Nursing Facility, Home Health, Case Management.

  • Knowledge of referral processes, (CMS) Medicare coverage criteria, UM coverage criteria (i.e. DRGs, Interqual, MCG (Milliman), Home Health criteria, community resources and FHCP networks preferred.

  • Must have a valid driver's license and reliable transportation for travel requirements.



•EOE/M/F/Vet/Disabled

 

Job Summary
Start Date
As soon as possible
Employment Term and Type
Regular, Full Time
Required Experience
3+ years
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