Supvr, Complex Case Mgmt Job
Location: Omaha Nebraska
Description: Coventry Health Care is at present recruited Supvr, Complex Case Mgmt Job right now, this vacancy will be placed in Nebraska. For complete informations about this vacancy opportunity kindly read the description below. Description:
Coventry Health Care is an organization of people dedicated to serving the health care needs of our community.
We foster team involvement, encourage ! continuing education, and reward success.
At Coventry Health Care, we strive to maintain an organization with energetic, growth-minded, and loyal employees who are continually challenged to make a difference.
GENERAL SUMMARY
In this position you will be responsible for the daily supervision of the Complex Case Management team. Serves in an active managerial role to assist in the development, implementation, and evaluation of the utilization management process.
Join a team that offers the family feel of a local organization with the support and resources of a Fortune 500 company!
We offer a competitive salary, a comprehensive benefits package, tuition reimbursement, and a 401(k) plan with company match and immediate vesting, and excellent growth opportunities.
ESSENTIAL RESPONSIBILITIES
- Provides oversight and direction to the specific members in the area of complex case management; including, staffing, training, m! onitoring, and evaluating.
- Reviews the timeliness, ap! propriateness, and medical necessity of the utilization processes performed by the staff. Prepares reports detailing the monitored activities.
- Actively participates in the development, implementation, and oversight of the department’s activities; serves in an adjunct role for policy and procedure development and implementation.
- Assists in the identification of issues which may adversely impact the attainment of department goals/initiatives (i.e., inpatient bed days per thousand, outpatient surgery utilization, etc.)
- Collaborates with other departments to educate providers/vendors and members regarding network providers/specialists benefits and utilization management policies and procedures.
- Attends meetings with internal workgroups and external business associates.
- Assists in the identification and triage of potential quality improvement issues and is responsible for assuring that these issues are reported to the Quality Improv! ement department.
- Performs other duties as required.
JOB SPECIFICATIONS
- Registered nurse with current state RN license.
- Bachelor’s degree OR certification as a Case Manager OR professional certification in a clinical specialty and previous (at least 3 years) experience as a Case Manager.
- Successful acquisition of case management certification is required if directly supervising the case management process for 3 or more years.
- Significant experience (usually 2+ years) in utilization management.
- Significant clinical experience (usually 3+ years).
- Previous supervisory experience (usually 2+ years).
- Regular local travel may be required.
referencing job requisition 1311638.
Coventry Health Care is an Affirmative Action/Equal Opportunity Employer, a! nd we are committed to building a talented and diverse team.
Job: Professionals
Primary Location: Omaha, NE, US
Other Locations: ,
Organization: 12000 - CHC of Nebraska
Schedule: Full-time
Job Posting: 2013-05-02 00:00:00.0
Job ID: 1311638
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If you were eligible to this vacancy, please email us your resume, with salary requirements and a resume to Coventry Health Care.
If you interested on this vacancy just click on the Apply button, you will be redirected to the official website
This vacancy starts available on: Fri, 03 May 2013 09:59:07 GMT