Medical Management - Supervisor Concurrent Review 145-4006

CommunityCare HMO Inc.; Tulsa (OK); On-site; USD 85,000 - 110,000; Full time

Job summary

CommunityCare HMO Inc. in Tulsa seeks an experienced nurse leader to supervise and coordinate daily workflow and staff leadership in our clinical operations.

Responsibilities include developing operating procedures, managing personnel and resources, interviewing and developing staff, and ensuring regulatory requirements are met. Qualifications include a nursing degree, Oklahoma RN license, 3+ years acute care experience, and 2 years management preferred.

Qualifications

• Nursing degree and active Oklahoma RN license.
• 3+ years of clinical nursing experience in an acute care setting.
• 2 years of management experience preferred.
• Strong written and oral communication skills.
• Proven ability to plan, organize, and implement procedural changes.
• Ability to lead, direct, and supervise staff smoothly.
• Knowledge of managed care and benefit plans.

Responsibilities

• Supervise and coordinate daily workflow and leadership of staff.
• Develop operating procedures and manage personnel and resources.
• Serve as a resource to department staff and resolve workflow problems.
• Assess workloads, assign personnel, and ensure regulatory requirements are met.
• Interview, hire, train, and evaluate eligibility personnel and contribute to policy updates.
• Attend departmental and facility meetings and perform other duties as assigned.

Skills

Plan and organize

Leadership

Decision making

Quantitative reasoning

Time management

Written and verbal communication

Microsoft Office

Managed care knowledge

Education

Accredited School of Nursing graduate

Oklahoma RN license

3+ years acute care nursing experience

2 years management experience preferred

Tools

Microsoft Office

Job description

Job Summary

Responsible for supervising and coordinating daily workflow and leadership of staff. Activities include developing operating procedures and managing personnel and resources.

Responsible for supervising and coordinating daily workflow and leadership of staff. Activities include developing operating procedures and managing personnel and resources.

Key Responsibilities

• Serves as a resource to the department staff by providing technical direction and resolving workflow problems or improvement opportunities within the department.
• Assesses individual workload and staffing patterns. Selects, assigns, and evaluates personnel, and recommends or initiates associated personnel actions. Takes caseload as needed to assist with staffing needs. Ensure authorization timeframes and regulatory requirements are met.
• Interviews, hires, trains, and reviews all eligibility personnel in addition to problem-solving and disciplinary actions. Participates in analysis of current policies and procedures and in the development of new or updated standard operating procedures and workflows.
• Attends departmental, interdepartmental, and facility meetings as needed.
• Performs other duties as assigned.

Qualifications

• Ability to plan, organize, schedule, and effect procedural changes.
• Ability to effectively lead, direct and supervise others.
• Ability to reason logically and to use good judgment when interpreting materials or situations.
• Ability to work quickly and accurately with quantitative information.
• Ability to organize time effectively and set priorities.
• Possess strong written and oral communication skills.
• Proficient in Microsoft applications.
• Knowledge of managed care and benefit plans.

Education/Experience

• Graduate from accredited School of Nursing.
• Current, active, unrestricted license to practice as Registered nurse (RN) in the State of Oklahoma.
• At least three years of clinical nursing experience in an acute care setting.
• 2 years of management experience preferred.

CommunityCare is an equal opportunity at will employer and does not discriminate against any employee or applicant for employment because of age, race, religion, color, disability, sex, sexual orientation or national origin