Managed Care Supervisor jobs in Lima, OH

 Functioning within the Health System’s mission, values, objectives and policies and procedures, the Supervisor of Care Coordination assists the Director of Case Management with the supervision of the Care Coordination team focusing on utilization review and Clinical Documentation including supervision and assignment of professional and non-professional staff in assigned areas. Duties also include coordination of staff functioning,; negotiation and procurement of care of patients to achieve quality and cost effective patient outcomes, focusing on length of stay,  documentation, and bed management initiatives.. This involves working collaboratively with the Director of Case Management and the interdisciplinary staff, internal and external to the organization. The Supervisor of the Care Coordination department participates in quality improvement processes directly related to transitions in care throughout the organization. Additionally, the Supervisor analyzes data for trends and patterns and/or opportunities for improvement; assists with preparing reports for various committees;  participates and directly gathers data for the Utilization Review Committee;  focuses on the oversight of quality daily transitions in care and improving processes and outcomes at the direct patient care level; and quality Documentation /Utilization processes.  The Supervisor will provide input for the budget; assist with payroll; hold responsibility for annual performance appraisals for the Care Coordination Managers, and data related to all Utilization/Documentation.

Education:  Graduate of an accredited school of nursing, BSN required. 

Licensure/Certification:  Valid unrestricted license with the Ohio Board of Nursing. Certification in case management and/or utilization review preferred. BLS required or obtained within 3 months of hire.

Experience:  Minimum of 2-3 years’ experience in utilization management, clinical documentation, case management, discharge planning or other cost/quality management program required. Minimum of three years’ experience in hospital clinical role required.  Previous lead/supervisory experience is preferred.

Skills:  Must possess critical thinking and positive communication skills, be motivated and self-directed, and have the ability to integrate numerous job responsibilities and work independently.  Must have knowledge of leading practice in clinical care and payer requirements, strong analytical, data management, and PC skills. Excellent communication skills and demonstrated ability to work collaboratively with health care professionals at all levels to achieve established goals and improve quality outcomes are also required.