Senior Case Management Supervisor — Care Coordination

SUNY Downstate Health Sciences University; New York (NY); On-site; USD 100,000 - 130,000; Full time

Job summary

The incumbent will lead utilization management, apply evidence-based criteria, and collaborate across disciplines to ensure appropriate care settings and reimbursement integrity. A Director of Care Coordination will supervise the position.

Qualifications

• Bachelor of Science in Nursing (BSN) required.
• Current, unrestricted New York State RN license.
• Five years of progressive clinical nursing experience, including at least three years in acute-care hospital case management or utilization management.
• Knowledge of medical necessity criteria and transitions of care.
• Ability to guide colleagues, prioritize complex workloads, and communicate with stakeholders.

Responsibilities

• Provide clinical oversight to case management activities and support timely, coordinated care.
• Collaborate with physicians and interprofessional teams to address barriers to discharge and transitions of care.
• Lead care coordination discussions, patient/family education, and discharge planning
• Oversee utilization management activities, reviews, and documentation in line with payer requirements.

Skills

Clinical nursing

Discharge planning

Interdisciplinary coordination

Communication

Education

BSN

CCM/ACM certification

MSN or related grad degree

Tools

Epic EMR

Job description

The incumbent will lead utilization management, apply evidence-based criteria, and collaborate across disciplines to ensure appropriate care settings and reimbursement integrity. A Director of Care Coordination will supervise the position.