The Care Coordination RN Supervisor is a leader with sound clinical skills and actively assists the Director/Manager in coordinating both clinical and operational duties. The Supervisor supervises departmental staff including RN Case Manager and RN Utilization Review staff. in an effective and efficient manner. This includes creating staff schedules, daily assignments, vacation approvals, timecard management, contributing toward department goals, and participating in necessary disciplinary actions for staff. Supports the daily logistics of the Care Coordination department.

Essential Duties:

• Coordinates and integrates various clinical resource management activities on intradepartmental, Interdepartmental and hospital wide levels.
• Hands on supervisor. Takes an assignment when necessary.
• Establishes and maintains performance improvement and quality control activities which support the Department and the hospital.
• Keeps staff’s licenses, certifications, fire card and annual health assessment’s up to date.
• Creates and publishes daily Triad Assignment by 8:00 AM
• Assists with staff evaluations. Plans for provision of services through appropriate levels of qualified, competent staff.
• Coordinates and prioritizes end of shift hand off of pending discharges to Float RNs.
• Supports and mentors staff.
• Manages escalations of discharge barriers.
• Provides for orientation, training and continuing education of staff.
• Actively assists with denial management and appeal activity.
• Works with staff to ensure necessary information is transmitted to payers in a timely fashion.
• Monitor space/resource requirements and utilization of outside resources.
• Assists with KRONOS time keeping.
• Proactively implements and maintains systems/protocols to improve operations.
• Completes eSRM reports.
• Is a team player.
• Displays a positive attitude.
• Performs other duties as assigned.

Required Qualifications:

• Bachelor's degree Nursing

• 5 years Clinical Experience
• 3 years Case management or utilization review experience
• 2 years Clinical Supervisory Experience

• Ability to work independently with minimal supervision, exercising judgment and initiative.
• Ability to manage multiple tasks with effective prioritization.
• Process oriented.
• Good computer skills.

Preferred Qualifications:

• Master's degree Nursing
• Knowledge of CM standards, UM standards, clinical standards of care, NCQA requirements, CMS guidelines, Milliman guidelines, InterQual guidelines, and Medicaid/Medicare contracts and benefit systems.

Required Licenses/Certifications:

• Registered Nurse - RN (CA DCA)
• Basic Life Support (BLS) Healthcare Provider from American Heart Association
• Fire Life Safety Training (LA City) If no card upon hire, one must be obtained within 30 days of hire and maintained by renewal before expiration date. (Required within LA City only)
• CM and/or UM training and/or certification.