Supervisor, Case Management
Location: Jackson Mississippi
Description: Centene Corporation is currently interviewing Supervisor, Case Management right now, this position will be placed in Mississippi. Detailed specification about this position opportunity kindly read the description below. Supervise the day-to-day operations of the case management function. Communicate with departmental and plan administrative staff to facilitate daily department functions. !
Position Responsibilities:
- Assure compliance with established referral, pre-certification and authorization policies, procedures and processes by related Medical Services staff.
- Assure compliance with established onsite and concurrent review, case management, referral, pre-certification and authorization policies, procedures and processes.
- Assure compliance with emergency management policies, procedures and processes.
- Facilitate on-going communication between case management staff, utilization management staff and contracted providers.
- Assist with the implementation of policies and procedures regarding medical case management.
- Maintain compliance with federal and state regulations and contractual agreements.
- Coordinate and communicate medical service functions with other departmental functions.
- Act as medical resource for appeals function.
- Assist Medical Services staff with ! computer systems issues related to case management.
- C! onduct telephonic review of cases with doctors, hospitals, and other providers.
- Compile and review multiple reports for statistical and financial tracking purposes to identify case management trends and assist in financial forecasting.
Knowledge/Experience:
Nursing education. Thorough knowledge of a specialized or technical field such as clinical nursing, case and/or utilization management. At least 3 years of recent nursing experience in an acute care setting particularly in medical/surgical, pediatrics, or obstetrics. At least 1 year of case and/or utilization management experience. Data management experience preferred.
License/Certificates: Current state registered nursing license and driver’s license.
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If you were eligible to this position, please email us your resume, with salary requirements and a resume to Centene Corporation.
If you interested on this position just click on the Apply button, you will be redirected to the official website
This position starts available on: Sat, 07 Sep 2013 00:09:48 GMT