RN Case Management Supervisor
Location: Poughkeepsie, New York US
Requisition Number: 12245
Nuvance Health has a network of convenient hospital and outpatient locations — Danbury Hospital, New Milford Hospital, Norwalk Hospital and Sharon Hospital in Connecticut, and Northern Dutchess Hospital, Putnam Hospital Center and Vassar Brothers Medical Center in New York — plus multiple primary and specialty care physician practices locations, including The Heart Center, a leading provider of cardiology care, and two urgent care offices. Non-acute care is offered through various affiliates, including the Thompson House for rehabilitation and skilled nursing services, and the Home Care organizations.
The Supervisor of RN Case Managers is responsible for oversite of the RN CMs providing the utilization management component of case management with the underlying objective of enhancing the quality clinical outcomes and patient satisfaction while managing the cost of care and providing timely and accurate clinical information to payors.
Oversee day to day operations within span of control, resolving problems as necessary, and ensuring that operations are efficient, compliant, safe, and of the highest possible quality.
Responsible for personnel management to include; onboarding and training, and performance improvement counseling. Completes annual performance evaluations and provides professional coaching and career path guidance
Assists in evaluating program outcomes as requested; assists with analysis and addressing variances in expected outcomes.
Acts as clinical expert to promote development and updates of policies and procedures that reflect current standards of practice for RN Case Managers focusing on appropriate use of medical necessity criteria that determines appropriate level of care throughout the continuum of care and the appropriate use of resources.
Collaborates with Physician Advisor on potential Denials, outlier cases, and supports the denials management processes within the Department.
Collaborates with third party payors to proactively anticipate denial of payment
Maintain contemporary professional knowledge and education.
Demonstrates regular, reliable and predictable attendance.
Performs other duties as required.
·Minimum three (3) years experience as a RN CM including utilization management experience
·Bachelor’s Degree in Nursing
·Prefer: Master’s Degree in Nursing
Have a comprehensive knowledge of InterQual and MCG criteria
Have a clear and precise knowledge of CoPs pertinent to Utilization Management and Utilization Plan.
·NYS RN License
Location: Vassar Brothers Medical Center
Work Type: Full-Time
Standard Hours: 8.00
Work Schedule: DAY 1
Work Shift: Monday- Friday 8-4:30 No Weekend or Holiday Requirement
Org Unit: 1190
Department: Care Coordination
* Some manual skills / motor coord & finger dexterity
* Sedentary/light effort. May exert up to 10 lbs. force
* Generally pleasant working conditions.
* Little or no potential for occupational risk
EOE, including disability/vets.
We will endeavor to make a reasonable accommodation to the known physical or mental limitations of a qualified applicant with a disability unless the accommodation would impose an undue hardship on the operation of our business. If you believe you require such assistance to complete this form or to participate in an interview, please contact Human Resources at 203-739-7330 (for reasonable accommodation requests only). Please provide all information requested to assure that you are considered for current or future opportunities.
State: New York
Community / Marketing Title: RN Case Management Supervisor
Health Quest and Western Connecticut Health Network have combined to form a new nonprofit health system. The name for the new health system will be Nuvance Health. The new health system was created to provide communities across New York’s Hudson Valley and western Connecticut with more convenient, accessible and affordable care.
EEO Employer Verbiage:
Location_formattedLocationLong: Poughkeepsie, New York US
Job Number: 37962