Care Management Supervisor

Pruitthealth Corporation; Norcross (GA); On-site; USD 75,000 - 95,000; Full time

Job summary

PruittHealth Corporation in Norcross, GA, seeks a Care Management Supervisor to oversee day-to-day activities of the Care Management Department and assist in delegating duties to the Care Management Assistants.

The role emphasizes partnership relations, staff recruitment, training, and quality patient care, with responsibilities spanning audits, customer service, privacy, and coordination across departments.

Qualifications

• Knowledge of commercial insurance fundamentals.
• Effective communication with payers, clients and providers.
• Working knowledge of computers, including MS Office.
• Understanding of state and federal regulations.

Responsibilities

• Establish positive partner relations and promote high partner morale.
• Recruit and onboard Care Management Assistant staff with required qualifications.
• Develop and implement an orientation program for partners.
• Serve as liaison between commercial contracted vendors and customers.
• Create in-service schedules to ensure staff have skills for quality care.
• Perform routine chart audits to ensure quality case management.
• Provide back-up coverage as needed.
• Handle customer complaints expeditiously per policy.
• Ensure Care Management Assistant staff meet customer service standards.
• Maintain privacy and confidentiality of protected health information.

Skills

Commercial insurance knowledge

Communication skills

MS Office proficiency

Regulatory understanding

Education

Bachelor’s Degree Preferred

BSN preferred or related managed care experience

Job description

Job Description - Care Management Supervisor (2611839)

Care Management Supervisor - 2611839

Description

JOB PURPOSE

Responsible for assisting the oversight and day to day activities of the Care Management Department Care Management Assistants. The person holding this position will assist in delegating the responsibilities for carrying out the assigned duties and responsibilities of the Care Management Department Care Management Assistants.

KEY RESPONSIBILITIES

• 1.Implements partner relations practices necessary to establish a positive partner relationship and promote a high level of partner morale.
• 2.Responsible for recruitment and employment of Care Management Assistant staff, ensuring that they have the necessary qualifications to perform their job descriptions.
• 3.Participates in the development and implementation of an orientation program for each partner.
• 4.Serves as the liaison between Commercial contracted vendor and our customers.
• 5.Responsible for developing an in-service schedule for the Care Management Assistant staffthat ensures that members of the department have skills necessary to ensurequality care.
• 6.Performs routine chart audits to ensure quality case management.
• 7.Provides back-up coverage.
• 8.Handles customer complaints expeditiously and according to policy
• 9.Ensure that Care Management Assistant staffis meeting company standards of customer service.
• 10.Maintains the privacy and confidentiality of protected health information, as well as sensitive information pertaining to other partners of PruittHealth
• 11.Facilitates clear information passage within and among departments involved.
• 12.Keeps supervisor informed of daily activities and issues. Purposes solutions to all issues.
• 13.Must get along with co-workers; maintain effective relationships with management staff, partners and the general public.
• 14.Must deliver exceptional customer service at all times.
• 15.May be responsible for a small caseload.
• 16.Performs other roles, administrative tasks and related duties as required by supervisor.
• 17.Must have timely, regular attendance.
• 18.Attend professional training as directed.

KNOWLEDGE, SKILLS, ABILITIES

• Knowledge of commercial insurance is fundamental. Knowledge of the Fundamentals of Case Management
• Ability to communicate effectively with payers, clients and providers essential.
• Must have working knowledge of computers, including Microsoft office programs.
• Understanding of state and federal regulations crucial.

MINIMUM EDUCATION REQUIRED

Bachelor’s Degree Preferred - BSN preferred and or commercial managed care or case management organization

MINIMUM EXPERIENCE REQUIRED

• 3-5 yearsexperience preferable in a commercial managed care or case management organization or post acute provider environment
• Equivalent combination of experience and training which provides the required knowledge, skills, and abilities.

Family Makes Us Stronger

Our family, your family, one family. Committed to loving, giving, and caring. United in making a difference.

As an Equal Employment Opportunity employer, all qualified applicants will receive consideration without regard to race, color, religion, sex, national origin, disability, or veteran status.

For Florida Job Postings Only:

For more information regarding Florida’s Care Provider Background Screening Clearinghouse Education and Awareness, please visit https://info.flclearinghouse.com