Supervisor, Utilization Management
- Facilitates collaborative management of patient care across the continuum, intervening as necessary to remove barriers to timely and efficient care delivery and reimbursement.
- Supervises the staff with all care management processes, including LOS, throughput, patient flow and denials and appeals follow up.
- Applies process improvement methodologies in evaluating team member's documentation.
- Ensures that multidisciplinary rounds and team huddles are occurring.
- Provides direction to the multidisciplinary team as needed in difficult cases.
- Obtains, interprets and presents metrics related to care management.
- Attends key meetings and presents the information about existing case management processes.
- Develops the performance improvement plan of the care manager, documents performance and provides performance feedback, evaluates the work of the team member and provides reward and recognition for proper and efficient performance.
- Determines areas of opportunities and suggest process improvement.
- Follows HR policies for performance and disciplinary action. Responsible for disciplinary action and performance improvement plans when appropriate.
- Participates in departmental preparation for regulatory visits and compliance audits.
- Coordinates/facilitates patient care progression throughout the continuum by working collaboratively with the multidisciplinary team.
- Collaborates with ancillary departments to ensure accuracy of patient demographic and insurance information.
- Assists in the collection and reporting of indicators tracking efficiency of case management processes.
- Uses data to drive decisions and plan/implement performance improvement strategies related to assigned staff, including fiscal, clinical, and patient satisfaction data.
- Collaborates with Physician Advisors,/Hospitalist in needs related to Case Management and difficult cases.
- Maintains annual competencies and ensures training and continuing education of the team in applicable platforms. (Epic, Xsolis Cortex, BI, Google Suites)
- Assumes responsibility for supervision of other case management care coordination managers in the absence of a Supervisor.
- Other duties and/or projects as assigned.
- Adheres to HMH Organizational competencies and standards of behavior.
- Bachelor's degree, Nursing or Master's Degree in Social Work.
- At least 3 years full time experience in an acute care setting.
- Familiar with hospital resources, community resources, and/or resource/utilization management.
- Care coordination, case management or discharge planning experience.
- Effective decision-making /problem-solving skills, demonstration of creativity in problem-solving, and influential leadership skills.
- Excellent verbal, written and presentation skills. Moderate to expert computer skills.
- Excellent written and verbal communication skills.
- Proficient computer skills that may include but are not limited to Microsoft Office and/or Google Suite platforms.
- Registered Nurse (RN) with current New Jersey (NJ) License, or Licensed Social Worker (LSW) or Licensed Clinical Social Worker (LCSW).
- Case Management certification by a nationally recognized organization within 1 year.
- Basic Cardiac Life Support Certificate.
Minimum rate of $107,952.00 Annually HMH is committed to pay equity and transparency for our team members. The posted rate of pay in this job posting is a reasonable good faith estimate of the minimum base pay for this role at the time of posting in accordance with the New Jersey Pay Transparency Act and does not reflect the full value of our market-competitive total rewards package. The starting rate of pay is provided for informational purposes only and is not a guarantee of a specific offer. Posted hourly rates may be stated as an annual salary in the offer and posted annual salaries may be stated as an hourly rate in the offer, depending on the level and nature of the job duties and credentials of the candidate. The base compensation determined at the time of the offer may be different than the posted rate of pay based on a number of non-discriminatory factors, including but not limited to:
- Labor Market Data: Compensation is benchmarked against market data to ensure competitiveness.
- Experience: Years of relevant work experience.
- Education and Certifications: Level of education attained, including specialized certifications, credentials, completed apprenticeship programs or advanced training.
- Skills: Demonstrated proficiency in relevant skills and competencies.
- Geographic Location: Cost of living and market rates for the specific location.
- Internal Equity: Compensation is determined in a manner consistent with compensation ranges for similar roles within the organization.
- Budget and Grant Funding: Departmental budgets and any grant funding associated with the job position may impact the pay that can be offered.
HACKENSACK MERIDIAN HEALTH (HMH) IS AN EQUAL OPPORTUNITY EMPLOYER
All qualified applicants will receive consideration for employment without regard to age, race, color, creed, religion, sex, sexual orientation, gender identity or expression, pregnancy, breastfeeding, genetic information, refusal to submit to a genetic test or make available to an employer the results of a genetic test, atypical hereditary cellular or blood trait, national origin, nationality, ancestry, disability, marital status, liability for military service, or status as a protected veteran.
Our Network
Hackensack Meridian Health (HMH) is a Mandatory Influenza Vaccination Facility
As a courtesy to assist you in your job search, we would like to send your resume to other areas of our Hackensack Meridian Health network who may have current openings that fit your skills and experience.
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