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Pediatric Professional Care Manager, Supervisor (RN)

  • Job ID: 156808540
  • Status: Full-Time
  • Regular/Temporary: Regular
  • Hours:
  • Shift: Day Job
  • Facility: UPMC Health Plan
  • Department: Medical Mgmt Medicaid
  • Location: 600 Grant St, Pittsburgh PA 15219
  • Union Position: No
  • Salary Range: $32.87 to $56.12 / hour

Description

Are you an experienced pediatric nurse with prior homecare experience? Are you looking to move your career towards leadership? UPMC Health Plan is hiring a full-time Supervisor of Pediatric Care Management (RN) to oversee the mobile care managers in our Medical Management department.

The position will work standard daylight hours, Monday through Friday.  The Mobile Supervisor will travel in the field to perform supervision of mobile care managers conducting visits in member’s homes.  The role requires at least 50% travel in Western PA as well as periodic work from the US Steel Tower in downtown Pittsburgh.

The Pediatric Program at UPMC Health Plan is offered to families enrolled in our insurance products. Experienced pediatric nurses and social workers serve as health coaches from a child's birth through the first year of life. As a Mobile Supervisor, you are responsible for oversight of day-to-day care coordination functions performed by a staff of nurses and social workers who provide mobile care management in member’s homes in the community as well as virtual AnywhereCare visits.  The team works collaboratively with each member to ensure they do not experience gaps in care.

Your work as Mobile Supervisor will include the direct supervision, coaching and counseling of staff. You will monitor mobile care manager 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 to achieve department goals, as well as contributing to or completing performance reviews.

Responsibilities:

  • Ensure staff receives, understand and adhere to applicable regulatory/ compliance guidelines related to their departmental expectations (I.E. NCQA, DPW, CMS).
  • Conduct regularly scheduled team and individualized meetings to communicate information, ongoing education and/or individual performance feedback.
  • 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.
  • Monitor, coach and report staff productivity and adherence to regulatory and work flow standards. Manage staff schedules to ensure that departmental goals are met
  • Contribute to the development, implementation and annual review of departmental policies and procedures.
  • 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.
  • Collect data, validate data where possible, prepare reports and assist teams in analysis and monitoring of key utilization targets and trends.
  • 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.
  • Assess staff member's ability to engage members and provide coaching to increase the use of motivational techniques. Complete performance evaluations within departmental timeframes
  • 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.

 

Qualifications

  • Bachelor's degree in nursing or related field required.
  • 2 years of nursing experience required.
  • 4 years of care manager experience required.
  • Managed care experience preferred.
  • Homecare experience preferred.
  • Prior experience with maternal-child programming preferred.
  • Two years of supervisory or leadership experience preferred.
  • 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 (RN)

UPMC is an Equal Opportunity Employer/Disability/Veteran

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   Current UPMC employees must apply in HR Direct