Job Description

Job Title: Supervisor, Care Management (RN) - CMI
Job ID: 686359
Status: Full-Time
Regular/Temporary: Regular
Hours:
Shift: Day Job
Facility: UPMC Health Plan
Department: Pop Health Case Mngt
Location: 600 Grant St, Pittsburgh PA 15219

Description

Are you an experienced nurse with a firm knowledge of care coordination? Are you looking to move your career towards leadership? We have a unique opportunity you won't want to miss out on! UPMC Health Plan is hiring a full-time Supervisor of Care Management (RN) to support our Community Medicine Inc. team.

This position will be based in our office located in Downtown Pittsburgh, but will travel to various sites in Allegheny County and surrounding areas. Mileage is reimbursed.

The position will work standard daylight hours, Monday through Friday.

As Supervisor, you are responsible for oversight of day-to-day care coordination functions performed by a staff of nurses who may work from home, provide telephonic outreach from Pittsburgh, or work on site in our partner facilities. This dynamic team works closely with our members who receive care through these partnerships. The team works collaboratively with each facility to ensure the member does not experience gaps in care.

Your work as Supervisor will include the direct supervision, coaching and counseling of staff. You will monitor staff workload, assignments, and productivity. You will apply your expertise to assist care managers with problem solving related to complicated member cases.

Additionally, you will have the unique opportunity to participate in the recruitment of and orientation for new clinical staff. You will continue to provide mentorship to staff in order to achieve department goals, as well as contributing to or completing performance reviews.


Responsibilities:
  • Assess staff member's ability to engage members and provide coaching to increase the use of motivational techniques. Complete performance evaluations within departmental timeframes
  • Collect data, validate data where possible, prepare reports and assist teams in analysis and monitoring of key utilization targets and trends.
  • Conduct regularly scheduled team and individualized meetings to communicate information, ongoing education and/or individual performance feedback.
  • Contribute to the development, implementation and annual review of departmental policies and procedures.
  • Contribute to the development, implementation, and evaluation of clinical programs within the team or department. Assist with integrating HP programs across the Health System and vendors as needed.
  • Ensure staff receives, understand and adhere to applicable regulatory/ compliance guidelines related to their departmental expectations (I.E. NCQA, DPW, CMS).
  • Facilitate staff orientation and on boarding for new staff. Monitor staff participation in mandatory education and competency assessment requirements at the system, Health Plan, and department level.
  • Monitor, coach and report staff productivity and adherence to regulatory and work flow standards. Manage staff schedules to ensure that departmental goals are met
  • Participate in interdisciplinary treatment team meetings to facilitate the development of appropriate and comprehensive plans of care. Assist staff in making referrals to community or governmental agencies.
  • Serve as a resource to staff and other Health Plan departments to identify opportunities for improvements, quality of care concerns, and barriers to care coordination. Utilize evidence based practice to support improvement in care / health / utilization management.

Qualifications

  • Bachelors degree in nursing or related field required
  • 4 years of care manager related experience required
  • Managed care experience preferred
  • Prior supervisory or leadership experience a plus, but not required
  • Case management certification or approved clinical certification within one year of hire
  • Ability to analyze data and monitor trends required
  • Proficiency with Microsoft Office products
  • Excellent interpersonal and communication skills (verbal and written)
  • Ability to collaborate effectively with physicians and other health care professionals
  • Strong organizational and problem solving skills with ability to make decisions independently
  • Ability to develop and maintain effective team-focused working environment
Licensure, Certifications, and Clearances:
  • Case management certification or approved clinical certification within one year of hire or 1 year health plan management experience required
  • Registered Nurse

UPMC is an equal opportunity employer. Minority/Females/Veterans/Individuals with Disabilities

Salary Range: $30.89 to $52.76

Union Position: No

At UPMC, our shared goal is to create a cohesive, positive, experience for our employees, patients, health plan members, and community. If you too are driven by these values, you may be a great fit at UPMC!

QUALITY & SAFETY
DIGNITY & RESPECT
CARING & LISTENING
RESPONSIBILITY & INTEGRITY
EXCELLENCE & INNOVATION

UPMC provides a total rewards package that can help you achieve the goals you have for your career and your personal life. Whether you want to learn a new skill through a training course, reach personal health and wellness targets, become more involved in your community, or follow a career path that provides you with the right experience to be successful, UPMC can help you get to where you want to be.



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