Supervisor Case Manager Long-term Care - Registered Nurse (RN) Delaware

Highmark Health; Brasil; Híbrido; BRL 358.000 - 669.000; Tempo integral

Resumo da oferta

A healthcare organization is seeking a Case Manager Supervisor in Brazil. This full-time role involves managing a team of case managers, enhancing member benefits, and conducting field visits. Candidates should have experience in long-term care or public health, with strong leadership and communication abilities. The position requires travel and offers a competitive salary ranging from $67,500.00 to $126,000.00, based on experience.

Qualificações

• 3 years of experience in long-term care, home health, or hospice.
• Registered Nurse or Licensed Practical Nurse with 2 years of relevant experience.
• Preferred: Certified Case Manager and supervisory experience.

Responsabilidades

• Manage a team of community-based Case Managers.
• Promote quality member outcomes and optimize member benefits.
• Conduct ride-alongs for support and quality assurance.

Conhecimentos

Leadership

Communication skills

Analytical skills

Collaboration

Multi-tasking

Formação académica

Bachelor's degree in Social Work or health services

Master’s degree in Social Work or health services

Descrição da oferta de emprego

Overview

Company : Highmark Inc.

Job Description : This role manages a team of Case Managers to promote quality member outcomes, optimize member benefits, and ensure effective use of resources for members enrolled in DSHP Plus LTSS. Provides direct oversight to Case Managers and can assist in day-to-day responsibilities as needed. This is a full-time, community-based position requiring frequent travel within the assigned territory in Delaware.

Responsibilities

• Manage a team of community-based Case Managers.
• Promote quality member outcomes to optimize member benefits and promote effective use of resources.
• Act as a role model to staff and assist in day-to-day activities as needed.
• Ensure care is medically appropriate, high quality, and cost effective.
• Conduct frequent ride-alongs and shadowing of Case Managers for hands-on support, quality assurance, and training opportunities.
• Apply clinical knowledge to work with facilities and providers for care coordination.
• Participate in rounds with the Medical Director.
• Review documentation and processes for consistent practice and identify opportunities for growth.
• Initiate and implement process improvements.
• Assist Case Managers in solving challenging situations and overcoming obstacles to meeting member needs.
• Identify and escalate issues appropriately and suggest new approaches to complex problems.
• Ensure all staff meet the minimal qualifications of their positions and pursue ongoing staff development, counseling, and education.
• Ensure direct reports maintain compliant process and documentation aligned with regulatory agencies (NCQA, URAC, CMS, DOH, DOL).
• Develop and implement workload distribution modifications in compliance with Delaware Case Manager caseload requirements.
• Recruit, select, orient, evaluate, counsel, and develop performance improvement plans; promote and terminate per policy; encourage career development and support of staff.
• Adhere to privacy practices, HIPAA, and quality performance standards.
• Perform other duties as assigned or requested.

Qualifications

Required

• Bachelor's degree in Social Work or in health, human, or education services and 3 years of experience in long-term care, home health, hospice, public health, or assisted living.

Or

• Master’s degree in Social Work or in health, human, or education services and 1 year of experience in long-term care, home health, hospice, public health, or assisted living.

Or

• Registered Nurse or Licensed Practical Nurse and 2 years of experience in long-term care, home health, hospice, public health, or assisted living.

Substitutions

• Registered Nurse or Licensed Practical Nurse and 2 years of experience in long-term care, home health, hospice, public health, or assisted living in lieu of Bachelor\'s degree.

Preferred

• Registered Nurse
• Two years of supervisory or managerial experience.
• Certified Case Manager (CCM)
• Experience working with HIV/AIDS population
• Experience working with behavioral health population
• Experience working with developmental disabilities population
• Two years in home clinical or case management experience
• Medicare and Medicaid experience
• Managed care experience

Skills

• Leadership and ability to relate to all levels of management, staff, and external partners
• Collaboration, motivational, and analytical skills
• Ability to multi-task in a fast-paced environment
• Excellent written and verbal communication skills
• Ability to analyze data, measure outcomes, and develop action plans
• Team player with strong analytical and organizational skills
• Ability to prioritize work and meet deadlines
• Proficiency with Word, Excel, Internet, and Outlook
• Reliable transportation to travel within the assigned territory
• Ability to meet regulatory deadlines
• Dedicated home workspace and compliance with telecommuter policies
• Experience with geriatric, behavioral health, and home health populations
• Understanding of cultural competency in addressing targeted populations
• Experience with electronic documentation systems
• Experience with cost neutrality and budgeting

Scope of Responsibility

Does this role supervise/manage other employees?

Yes

Work Environment

Travel is required: Yes

Compliance and Other

Disclaimer: The job description indicates the general nature and essential duties and responsibilities of work performed by employees in this job title and may not contain a comprehensive list of all duties and qualifications required.

Compliance Requirement: This position adheres to the ethical and legal standards and behavioral expectations in the code of business conduct and company policies. All employees must protect confidential information and comply with HIPAA and the company\'s privacy and information security policies. Also, employees must comply with the company\'s Code of Business Conduct and applicable laws, rules, and regulations.

Pay Range

Minimum: $67,500.00

Maximum: $126,000.00

Base pay is determined by qualifications, experience, and other factors. The displayed salary range does not reflect geographic differentials that may apply.

Highmark Health and its affiliates prohibit discrimination based on protected characteristics and require accessibility accommodations upon request. For accessibility or accommodation requests, contact HR Services Online at [e-mail].