Case Management Supervisor - Social Work

Chicago, IL (On-site)

$37/hr – $56/hrSenior Level5+ years expFull time

Posted 3 weeks ago

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Job Summary

Own and optimize case management oversight across admission to discharge, ensuring medical necessity, cost containment, and alignment with InterQual and Milliman criteria.

  • Lead supervision of Social Worker Case Managers, RN Case Managers, UR Tech, Discharge Planners, and collaboration with the MRC on peer reviews and appeals.
  • Oversee the continuum of care from admission through discharge with a focus on quality, resources, and comprehensive medical record reviews.
  • Anchor decision-making around clinical necessity and intensity of service to drive cost-effective outcomes.

Job Description

Responsibilities

  • The working Supervisor of Case Management is responsible for providing supervision to the Social Worker Case Managers, RN Case Managers, UR Tech, and Discharge Planners; as well as working with the facility Medical Review Coordinator (MRC) on all cases of Peer to Peer review, outcomes and initial appeal requests.
  • The Case Management Supervisor provides oversight for the quality and resources management of all patients that are admitted to the facility from the point of their admission and across the continuum of the health care management.
  • Works on behalf of the advocate, promoting cost containment and demonstrates leadership to integrate the health care providers to achieve a seamless delivery of care.
  • The methodology is designed to facilitate and insure the achievement of quality, clinical and cost effective outcomes and to perform a holistic and comprehensive admission and concurrent review of the medical record to assure all parameters for MCG/Milliman criteria/InterQual which includes the medical overview to find medical necessity, intensity of service and severity of illness.

Requirements

  • Licensed clinician in your state.
  • At least one-year experience in case management, discharge planning or management,
  • Experience and knowledge in basic to intermediate computer skills.

Preferred

  • CCM or obtained within 1year
  • Minimum 5 years of acute care experience
  • Current BCLS certificate preferred.
  • Knowledge of Milliman Criteria and InterQual Criteria preferred.

Benefits

  • competitive compensation and a comprehensive benefits package that provides employees the flexibility to tailor benefits according to their individual needs
  • Total Rewards package includes, but is not limited to, paid time off, a 401K retirement plan, medical, dental, and vision coverage, tuition reimbursement, and many more voluntary benefit options
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Prime

Prime Global Products specializes in pneumatic and cordless tool manufacturing. We are committed to developing products with top of the line features at 20% - 50% less cost, and sell tools to the nation's largest brands and retailers. Our team offers .com drop shipments, small order fulfillment, and outstanding US-based after sales services - all backed by industry leading product warranties.

Founded in 2008
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