FLSA Status

EXEMPT

Job Role Summary

The RN case manager supervisor of Transition Support is a member of the leadership team within the Transition Support Department who provides daily oversight and guidance, support and hands on assistance primarily to the inpatient and emergency department RN Case Managers as well as other members of the team and other ancillary inpatient TSD staff.  The RN Case manager supervisor works in tandem with the Medical Social Work Supervisor and serves to offer guidance related to inpatient work processes and serves as a catalyst to lead change as it relates to the changing health care environment.  The RN Case manager supervisor acts as an advocate for patients, providers and staff, ensuring that quality and efficient care is delivered in a professional and efficient manner.  The RN Case manager supervisor supports administrative leadership functions and represents other members of the departmental leadership in times of their absence.  

Essential Functions and Responsibilities

•    Collaborates and disseminates information to inpatient team ensuring that all members are up to date on expectations and regulatory requirements 
•    Responsible for the oversight of the inpatient nurse case managers within transition support
•    Responsible for directing departmental human resource activities (screening applicants, performance management and scheduling) for the Inpatient Team
•    Identifies opportunities for operational design enhancement and reports to departmental leadership
•    Stays current in the responsibilities and roles of staff within the care transitions team and disseminates shared information with the interdisciplinary staff
•    Represents the department in all activities when other leadership is unavailable
•    During time that inpatient is short staffed, supervisor may be required to complete role as an inpatient team member.
•    Conducts departmental orientation for physician, nurses, and students as appropriate
•    Utilizes problem-solving skills to identity and facilitate problem resolution in team functioning
•    Participates in staff meetings and education programs for staff and community agencies as assigned
•    Responsible for continuous professional self-development
•    Monitors all staff time and daily attendance as well as approvals using the KRONOS time tracking system and makes appropriate corrections as required
 

Job Requirements

•    Must be licensed RN with at least 5 years of case management experience in similar environment
•    Must have a minimum of Bachelor’s degree in nursing 
•    Minimum of two-year supervisory experience
•    Previous managed care experience 
•    Medicaid experience
 

Knowledge, Skills & Abilities

•    Must demonstrate current knowledge of inpatient case management experience 
•    Effective communication skills
•    Must possess analytical, psychosocial assessment and counseling skills
•    Ability to work cooperatively with multi-discipline teams in situations requiring a high degree of flexibility, creativity, initiative
•    Ability to apply social service techniques/principles including evaluation, intervention, and case management
•    Ability to perform duties independently under the direction of specified supervisor
•    Ability to recognize own limitations and seek assistance from appropriate resources as needed
•    Knowledge of billing processes and payer requirements 
•    Knowledge of Medicare, Medicaid and Commercial Payer Regulations 
•    Knowledge of NCQA, RAC and MIC audit process 
•    Working knowledge of organization’s financial/billing systems, i.e., Siemen’s Invision, SAP, McKesson Star and the HIM/clinical documentation systems 
•    Working knowledge of UM and CM/DM documentation systems and resources 
•    Ability to support after hours related questions for on-call team members