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.