Telephonic Medical Case Management Supervisor

Tristar Insurance; South Carolina; Sur place; USD 110 000 - 118 000; Plein temps

Avantages offerts par ce poste

Medical, Dental, Vision Insurance

Life and Disability Insurance

401(k) Plan

Paid Holidays and Paid Time Off

Referral bonus

Résumé du poste

Tristar Insurance is seeking an experienced Supervisor to lead a clinical team in a remote setting. The role emphasizes staff coaching, performance management, and adherence to regulatory standards. A strong nursing background and CCM certification are preferred.

Responsibilities include directing operations, training staff, and ensuring quality outcomes while maintaining confidentiality and compliance with HIPAA. Travel may be required for meetings and oversight.

Qualifications

• RN with current unrestricted state licensure.
• Associate or bachelor’s degree in nursing and/or Master’s level or higher in Health, Psychology, or Social Services.
• Minimum 3 years of clinical practice experience.
• Certification as CCM (CRC, CDMS, or CRRN) or willingness to pursue.
• Workers’ Compensation case management and supervisor experience preferred.

Responsabilités

• Represent the company in a professional manner to internal and external customers and clients.
• Ensure team performance standards through ongoing training, coaching, quality assurance, and regular performance evaluations.
• Provide clinical, technical, and operational support and direction, including organization and department procedures.
• Monitor staff assignments and adjust based on staffing levels; provide coaching to improve staff productivity.
• Assist in training new staff and ongoing training to ensure staff competency.
• Review quality audits and promptly share audit results with associates, delivering education and training to improve performance.
• Collaborate with the Manager and TMC leadership to develop and implement performance measures; monitor associates on performance improvement plans.
• Complete annual reviews for direct reports with Manager input.
• Foster an environment that promotes teamwork, cooperation, respect, and diversity.
• Ensure staff compliance with Case Management laws and regulatory requirements; maintain alignment with TRISTAR’s policies.
• Maintain open communication among department staff and with management; participate in management, Quality Management Committee, client stewardship, and implementation meetings as necessary.
• Handle miscellaneous duties and special projects; stay current on workers’ compensation laws and rules to ensure proper recommendations; participate in ongoing continuing education as needed.

Connaissances

Leadership

Communication skills

Coaching

Team training

Formation

RN licensure

Bachelor’s degree in nursing

Master’s degree in Health, Psychology, or Social Services

Outils

Microsoft Word

Microsoft Excel

PowerPoint

Description du poste

Overview

Position: Supervisor – Experienced

Location: Remote (Involuntary Remote TMC – Remote, SC 29486) | Job Type: Full Time | Education Level: Masters | Salary: $110,000.00 – $118,000.00 per year

Responsibilities

• Represent the company in a professional manner to internal and external customers and clients.
• Ensure team performance standards through ongoing training, coaching, quality assurance, and regular performance evaluations.
• Provide clinical, technical, and operational support and direction, including organization and department procedures.
• Monitor staff assignments and adjust based on staffing levels; provide coaching to improve staff productivity.
• Assist in training new staff and ongoing training to ensure staff competency.
• Review quality audits and promptly share audit results with associates, delivering education and training to improve performance.
• Collaborate with the Manager and TMC leadership to develop and implement performance measures; monitor associates on performance improvement plans.
• Complete annual reviews for direct reports with Manager input.
• Foster an environment that promotes teamwork, cooperation, respect, and diversity.
• Ensure staff compliance with Case Management laws and regulatory requirements; maintain alignment with TRISTAR’s policies.
• Maintain open communication among department staff and with management; participate in management, Quality Management Committee, client stewardship, and implementation meetings as necessary.
• Handle miscellaneous duties and special projects; stay current on workers’ compensation laws and rules to ensure proper recommendations; participate in ongoing continuing education as needed.

Additional Functions and Responsibilities

• Excellent written and verbal communication skills for staff and client contact, presentations, and personnel management.
• Strong leadership with the ability to motivate staff and achieve results through teamwork.
• Ability to meet deadlines, manage multiple tasks, and work effectively under time constraints.
• Ability to attend meetings and travel overnight as needed.
• Computer proficiency with Microsoft Office (Word, Excel, PowerPoint) and ability to navigate multiple systems.

Knowledge

• Knowledge of case management and cost containment; adherence to URAC standards and company policies.
• Maintain confidentiality and knowledge of HIPAA and PHI regulations.

Education/Experience

• RN with current unrestricted state licensure; associate or bachelor’s degree in nursing and/or Master’s level or higher in Health, Psychology, or Social Services.
• Minimum 3 years of clinical practice experience.
• Certification as CCM (CRC, CDMS, or CRRN) or willingness to pursue.
• Workers’ Compensation case management and supervisor experience preferred.

Key Competencies

• Basic computer proficiency (Microsoft Office including Word, Outlook, Excel, PowerPoint) and ability to navigate multiple systems.
• Effective verbal and written communication skills.
• Ability to meet productivity and quality expectations.
• Organizational and prioritization skills to manage daily work independently.

Benefits

• Medical, Dental, Vision Insurance
• Life and Disability Insurance
• 401(k) Plan
• Paid Holidays and Paid Time Off
• Referral bonus