Supervises the day to day oversight of activities associated with Ambulatory Case Management nurses and support staff to ensure compliance with Case Management and SNP programs.
Independently analyzes and assigns coverage by allocating resources and directing the day to day activities to departmental advantage.
Identify, prepare and maintain Case Management reports as needed for both staff and management.
Assign, manage, and/or handle special projects delegated by Manager and Director and Provide support to Manager-Case Management Ambulatory Services, Director of Medical Management and Medical Directors.
Develop and implement quality and productivity standards then establish the expectations with the staff in the performance of their jobs.
Develop and maintain templates, forms, reports, and other tools that will assist the staff in meeting the needs of the department, patients and providers of the organization as it relates to utilization management.
Ensure any referrals processed by aligned staff are reviewed and completed in the EMR.
Interface with other departments to resolve issues associated with cases managed by the staff.
Identify, develop and conduct training for staff and/or coordinate with trainer for new hires or when additional training is needed.
Identify and resolve the root cause of problems associated with the Case Management area of responsibilities. Develop and implement a plan to address the issue.
Participate in quality improvement activities and committee reports and meetings for departmental specific processes.
Provide direction and assistance to less experienced staff.
Review, revise, and develop policies and procedures for the department as needed.
Evaluate personnel to coach, counsel and/or discipline employees as necessary to improve performance.
Monitor time and attendance of assigned staff.
Participate in other duties as assigned.
Ability to problem solve to logical conclusion and demonstrates initiative and responsibility