Supervisor, RN Case Management Full Time

Job Description

Job ID: 1188492
Employment Status: Full-Time
Your Career. Made Better.

Christian Hospital is an acute-care community hospital with 220 staffed beds, located in north St. Louis County. As a founding member of BJC HealthCare, the hospital has an expert medical staff and a diverse workforce of nearly 2,000 health care professionals who are dedicated to providing the absolute best care with the latest technology and medical advances. Christian Hospital is nationally recognized for stroke care and cardiology, and highly regarded for its excellence in emergency medicine, robotic surgery, orthopedic and spine surgery, pulmonology and wound care.

Our Northwest HealthCare campus, located six miles west of Christian Hospital in Florissant, offers the community 24-hour emergency care as well as a variety of outpatient services and physician practices.

The Case Management Department provides services through a collaborative process that assesses, plans, implements, coordinates, monitors, and evaluates options and services to meet an individual's needs. The Case Management Department is responsible for all acute care inpatients where needs have been identified or who have requested assistance, emergency department patients where needs have been identified, and community individuals who request assistance.


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Role Purpose

This position is responsible for assisting the Manager of Case Management Services in the areas of care management, utilization management, social work and denial and appeal management. Provides a lead and mentorship role to the other Case Management & Social Work supervisors. The scope of this position requires the Supervisor to be knowledgeable in Centers for Medicare and Medicaid Services (CMS) compliance regulations; Financial data as it relates to length of stay, impact of denials, avoidable days, outliers, Recovery Audit Contractors, etc.. Case/care management, especially progressive methodologies for managing continuum of care, readmissions; Health plan contracts; and Change management to inspire lean techniques for completing the required work.


Responsibilities

  • Manages individual(s) including but not limited to: hires, trains, assigns work, manages & evaluates performance, conducts professional development plans. Ensures that the productivity and actions of that group meet/support the overall operational goals of the department as established by department leadership.
  • May participate in the development of departmental staffing, revenue and/or expense budgets and having direct responsibility for adhering to those goals. This includes responding to changes in the business which may affect the ability to achieve the budget goals.
  • Supports the Department Manager in the daily operations of case management, utilization management, social work and denial and appeal management.
  • Assists the Manager with case coordination, precertification, and concurrent review programs to ensure maximal reimbursement, prevent financial loss to the hospital, and to minimize beneficiary (patient) liability
  • Assists with creating effective work plans that include, identifying the correct resources, processes, special department projects, staffing and space needed by the patient care area
  • Provides advisory/consultative support, builds collaborative relationships and integrates services/programs with other departments.
  • Participates in building an effective work unit through hiring, supervising and evaluating department staff

  • Minimum Requirements

     

    Degree

  • Bachelor's Degree
  • - Nursing

     

    Experience

  • 5-10 years
  •  

    Supervisor Experience

  • 2-5 years
  •  

    Licenses & Certifications

  • RN

  •  

    Preferred Requirements and Additional Job Information

     

    Degree

  • Master's Degree
  • - Bus/HC Admin/Nursing/related

     

    Experience

  • 10+ years
  •  

    Supervisor Experience

  • 5-10 years
  •  

    Licenses & Certifications

  • Case Management

  • Benefits Statement

    Note: not all benefits apply to all openings

    -  Comprehensive medical, dental, life insurance, and disability plan options
    -  Pension Plan*/403(b) Plan
    -  401(k) plan
    -  Tuition Assistance
    -  Health Care and Dependent Care Reimbursement Accounts
    -  On-Site Fitness Center (depending on location)
    -  Paid Time Off Program for vacation, holiday and sick time

    *Pension does not apply to Memorial Hospital, Memorial Hospital East, Memorial Medical Group, Alton Memorial or Parkland Health Center


    Legal Statement

    The above information on this description has been designed to indicate the general nature and level of work performed by employees in this position. It is not designed to contain or be interpreted as an exhaustive list of all responsibilities, duties and qualifications required of employees assigned to this job.

     

    Equal Opportunity Employer