St Francis Medical Center

Case Management Supervisor

St Francis Medical Center$77K — $117K *
Healthcare
Less than 5 years of experience
Job Overview by Ladders

Qualifications

  • Licensed clinician in the state of practice
  • Minimum one year of experience in case management or discharge planning
  • Basic to intermediate computer skills
  • CCM certification preferred within one year of hire
  • Minimum five years of acute care experience preferred
  • Current BCLS certification preferred
  • Familiarity with Milliman and InterQual criteria preferred

Responsibilities

  • Supervise Social Worker Case Managers, RN Case Managers, UR Tech, and Discharge Planners
  • Collaborate with the Medical Review Coordinator on Peer to Peer reviews and appeals
  • Oversee quality and resource management for admitted patients
  • Promote cost containment while ensuring quality care delivery
  • Conduct comprehensive admission and concurrent reviews of medical records
  • Facilitate seamless care integration among health care providers
  • Ensure adherence to MCG/Milliman/InterQual criteria for medical necessity and service intensity

Benefits

  • Paid time off
  • 401K retirement plan
  • Medical, dental, and vision coverage
  • Tuition reimbursement
  • Variety of voluntary benefit options
Full Job Description
Responsibilities

The working Supervisor of Case Management is responsible for providing supervision to the Social Worker Case Managers, RN Case Managers, UR Tech, and Discharge Planners; as well as working with the facility Medical Review Coordinator (MRC) on all cases of Peer to Peer review, outcomes and initial appeal requests. The Case Management Supervisor provides oversight for the quality and resources management of all patients that are admitted to the facility from the point of their admission and across the continuum of the health care management. Works on behalf of the advocate, promoting cost containment and demonstrates leadership to integrate the health care providers to achieve a seamless delivery of care. The methodology is designed to facilitate and insure the achievement of quality, clinical and cost effective outcomes and to perform a holistic and comprehensive admission and concurrent review of the medical record to assure all parameters for MCG/Milliman criteria/InterQual which includes the medical overview to find medical necessity, intensity of service and severity of illness.

Qualifications

EDUCATION, EXPERIENCE, TRAINING

Required qualifications:

1. Licensed clinician in your state.
2. At least one-year experience in case management, discharge planning or management,
4. Experience and knowledge in basic to intermediate computer skills.

Preferred qualifications:

1. CCM or obtained within 1year
2. Minimum 5 years of acute care experience
3. Current BCLS certificate preferred.
4. Knowledge of Milliman Criteria and InterQual Criteria preferred.

Pay Transparency

St. Mary's Hospital - Kankakee offers competitive compensation and a comprehensive benefits package that provides employees the flexibility to tailor benefits according to their individual needs. Our Total Rewards package includes, but is not limited to, paid time off, a 401K retirement plan, medical, dental, and vision coverage, tuition reimbursement, and many more voluntary benefit options. A reasonable compensation estimate for this role, which includes estimated wages, benefits, and other forms of compensation, is $37.12 to $56.26. The exact starting compensation to be offered will be determined at the time of selecting an applicant for hire, in which a wide range of factors will be considered, including but not limited to, skillset, years of applicable experience, education, credentials and licensure.

The company is dedicated to empowering its staff with a comprehensive, competitive benefits package, allowing them the freedom to customize their benefits to fit their unique needs. Our abundant resources, programs, and voluntary options serve as a foundation for individual growth and well-being. Learn more here: https://www.primehealthcare.com/benefitsthatmattermost/

Employment Status

Full Time

Shift

Days

About St Francis Medical Center

St. Francis Medical Center is a for-profit hospital in Lynwood, California, United States, owned by Prime Healthcare Services.
Learn more about St Francis Medical Center

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