Supervisor-Case Management

Rotating Weekends Required 

Job Summary: The Supervisor-Case Management, keeps pace with a progressive and proactive management team and utilizes discretion, independent judgment and critical thinking skills to ensure efficient and effective age-specific case and utilization management and social work services at Loma Linda University Medical Center, a Magnet recognized tertiary care academic medical center with multiple hospital campuses. Develops and maintains a collaborative, credible and trusting working relationship with the administrative team, physicians, nursing and social work leadership and the multidisciplinary healthcare team members. Maintains a system-wide perspective and objectivity when managing and facilitating the prioritization of care coordination, utilization review, case management and discharge planning to achieve desired clinical outcomes, patient safety within financial parameters. Ensures a safe, effective and efficient patient transition along the continuum of care. Influences the reduction of patient re-admission rates by ensuring patient, family and caregiver are well-prepared for discharge to home or alternate care setting by making a comprehensive assessment of high risk screening criteria, discharge needs and referrals. Supervises day to day activities of the in-house Case Management (CM) and Social Work (SW) staff and directs shift operations based on substantial knowledge of Medical Staff Bylaws, Rules and Regulations, Milliman Care Guidelines (MCG) criteria, LLUMC policies and procedures, and state and federal regulations. Serves as a resource to staff to remove barriers to patient placement and discharge. Commits to a customer service oriented culture. Participates in activities aiming to influence patient satisfaction ratings, increase revenue, reduce cost, and promote efficiency throughout the hospital through the implementation of organization-wide patient satisfaction strategic initiatives. Demonstrates a commitment to excellence and the exceeding of customer expectations by modeling leadership behavior in the context of institutional values, empowerment, alignment, creativity and education. Models expertise in service recovery methodologies and capably resolves issues from dissatisfied customers. Assists the Director of Case Management in supervision of employees, and exhibits effective leadership skills that embrace team members. Furthers a work environment of caring and cooperation among a culturally diverse workforce and patient population. Performs other duties as needed.

Education and Experience: Bachelor's Degree in Nursing required. Master's degree preferred. Minimum of two years' experience in case management in an acute care hospital setting required. Case Management certification preferred. Utilization Management knowledge required.

Knowledge and Skills: Substantial knowledge of case and utilization management practices, Social Work, state and federal healthcare regulations, finance, performance improvement, quality, patient safety, evidenced-based clinical practice standards, medical staff structure and legal aspects of care required. Knowledge of adult learning principles, management and problem-solving methodologies required. Exhibits professional behavior at all times. Able to speak, read and write legibly in English (and Spanish preferred) with professional quality; use computer, printer, and software programs necessary to the position, e.g., Word, Excel, Outlook, PowerPoint, electronic medical record, electronic event reporting program; relate and communicate positively, effectively, and professionally with others; be assertive and consistent in following and enforcing policies; work calmly and respond courteously when under pressure; lead, supervise, teach, and collaborate; accept direction; think critically; use sound judgment based on factual information and clinical knowledge; work independently with minimal supervision; meet deadlines; perform basic math and statistical functions; manage multiple assignments effectively; organize and prioritize workload; recall information with accuracy; pay close attention to detail; hear sufficiently for general conversation in person and on the telephone; identify and distinguish various sounds associated with the work place; see adequately to read computer screens, medical records, and written documents necessary to position.

Licensures and Certifications: Active California Registered Nurse (RN) license required. Basic Life Support (BLS) certification issued by the American Heart Association required.

 

Our mission is to continue the teaching and healing ministry of Jesus Christ. Our core values are compassion, excellence, humility, integrity, justice, teamwork and wholeness.