RN Supervisor - Care Management
Company: Martin Luther King, Jr. Community Hospital
Posted on: May 1, 2021
If you are interested please apply online and send resumes to
The Care Management Supervisor is a leadership position that
requires experience in care management, excellent clinical skills,
and leadership qualities. Reporting to the Manager of Care
Management, the Supervisor of Care Management has hospital-wide
accountability for overseeing care management and utilization
review processes which include: (1) inpatient admission with
continued and extended hospital stays, (2) discharge reviews (3)
inpatient medical necessity, (4) assurance of high quality care,
(5) efficient use of available care management resources, and (6)
Health Plan reimbursement categorical knowledge. The role requires
maintaining appropriate and up-to-date knowledge of RN scope of
practice, current state requirements, CMS Conditions of
Participation, EMTALA, The Patient Bill of Rights, AB1203, and
other Federal or State regulatory agency requirements specific to
Care Management, Utilization Review, and Discharge Planning. The
Supervisor of Care Management partners with the medical staff and
senior and mid-level Care Management leadership in making decisions
of how to resolve patient conflicts and advance acute care
processes. The Supervisor of Care Management utilizes scientific
evidence for creating and implementing best practices, and relevant
data to manage patient care and function as a support liaison for
the Care Management team. This position requires the full
understanding and active participation in fulfilling the Mission of
Martin Luther King, Jr. Community Hospital. It is expected that the
employee will demonstrate behavior consistent with the Core Values.
The employee shall support Martin Luther King, Jr. Community
Hospital's strategic plan and the goals and direction of the
quality and performance improvement process activities. The Watson
Model of Care is utilized throughout the delivery of care
ESSENTIAL DUTIES AND RESPONSIBILITIES
- Manages MLK's Homeless Policy and integrally involved in the
- Functions as a Super User training for the Care Collaborative
- Conducts ongoing education of staff on how to prepare thorough
documentation in the medical record
- Participates in integrated testing for the Care Collaborative
System and Cerner upgrades.
- Coordinates the new employees for system training.
- Makes sure that ESARFS are completed in a thorough and timely
- Responsible to coordinate the preceptor training schedule in
collaboration with the CM Educator and Manager.
- Participates in mapping and overseeing space allocations for
- Coordinates unit orientation of new employees.
- Creates well-articulated workflows, clinical pathways, and
teaching tools for education.
- Any other duties to assure the unit is ready each day..
Role Specific Duties and Responsibilities
- Functions as a nurse model in mitigating conflict, and
resolving care dilemmas utilizing conflict resolution skills.
- Monitors and supports the interdisciplinary team process to
facilitate timely care, assure quality of care to patients
throughout the hospital stay, and minimize adverse outcomes.
- Oversees the patient referral process and ensures
appropriateness to outside provider networks (Health Plans, IPA's,
FQHC's, SNFs, Board and Cares, Recuperative Care, Sub-acute cares,
and PCP/Specialty offices).
- Resolves conflicts relating to admitting services with Patient
Access and makes decisions in that regard by considering the needs
of the patient, payer, and provider.
- Enhances team knowledge by providing front line education
regarding UM, CM, and effective discharge planning.
- Communicates relevant elements of the health plan structure to
CM team, as determines is necessary.
- Conducts chart audits as necessary to reinforce documentation
and compliance requirements of CM department.
- Participates in multi-disciplinary and departmental meetings as
assigned by the Manager.
- Provides front line education in reaffirming CM processes in
collaboration with the CM Educator and/or SW Educator.
- Ensures that staff and others adhere to the Care Management
Department policies and procedures.
- Oversees implementation and maintenance of the Quality and
Performance Improvement Plan for the Care Management
- Ensures departmental reformation and project implementation to
- Considers the patient population served, age-specific criteria,
the Watson Model of Care, and other pertinent factors, as
appropriate, when engaging in all patient/family care and
- Understands and implements Milliman Care Guidelines relating to
best practices to determine patient disposition.
- Collaborates and works closely with onsite Hospitalists,
Intensivists, Emergency Physicians, and other members of the
Medical Staff. Physicians when needed.
- Prepares the Complex Cases for the SNF & HH weekly meetings &
presents potential patients
- Attends daily discharge huddle meetings with nursing to present
- Manages patient care gap when determines staffing is deficient,
- Participates in unit/department staff meetings as well as other
meetings as appropriate.
- Other duties to accomplish goals as necessary including working
as an RN CM if needed to ensure patient discharges.
- Works with ED & Inpatient CM to ensure that MCG reviews are
- BSN is required. Candidates with ASN and at least six (6) years
of Care Management experience will be considered in lieu of
- Minimum of one (1) to three (3) years of hospital inpatient
supervisory or related experience required and at least two (2)
years of hospital inpatient care management experience.
- Able to navigate and connect successfully with outside provider
networks (Health Plans, IPA's, and FQHC's).
- Internal candidates will be considered at management's
- Current California Nursing license
- Certification in Case Management (CMC or ACM) preferred but
must be obtained within 1 year after hire.
C. Special Skills/Knowledge
- Bilingual language skills preferred (Spanish)
- Basic computer skills
- Current Basic Life Support (BLS)
Equal Rights Employer
Applicants are considered for positions without discrimination on
the basis of race, color, religion, sex, national origin, age,
disability, genetic information, citizenship status, military
service, or any other status protected by federal, state, or local
laws. This application is intended for use in evaluating your
application for employment. Please click the link below to view the
E-verify or Right to Work information.
Keywords: Martin Luther King, Jr. Community Hospital, Burbank , RN Supervisor - Care Management, Executive , Burbank, California
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