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Supervisor Patient Care Coordination

Req #:  177821
Facility:  Advocate Physician Partners
Department:  Management/Supervisory
City:  Rolling Meadows
Posting Budget Status:  Day
Shift Type:  Full Time - Permanent
Posting FTE:  1

Position Requirements:

  • Current RN license in State of Illinois
  • Bachelors Degree in nursing or equivalent experience
  • Associates Degree required
  • 3 to 5 years clinical experience
  • 1 year previous utilization review, discharge planning, or case management experience
  • Ability to handle multiple tasks
  • Ability to intervene and handle difficult situations
  • Good verbal and written communications skills
  • Excellent interpersonal communication and problem-solving skills
  • Ability to work independently and prioritize assignments
  • Good computer and keyboard proficiency
  • Ability to handle multiple responsibilities
  • Demonstrated initiative in process improvement recommendations  
  • Ability to anticipate potential problems and intervene appropriately
  • Ability to work independently
  • Local travel
  • Ability to handle stress and high workload volumes
  • Flexible with work assignments
  • Ability to effectively communicate denial of services to members and providers
  • Ability and willingness to be cross-trained in other department activities.


Purpose:
To provide oversight of clinical activities of the medical services staff of the short term case management Transition Unit for Advocate Medical Group and Advocate Physician Partners, including the referral team, including but not limited to SNF/HH/DME/Day Rehab/Transplant/Research and Clinical Referrals. To ensure that members are provided with quality services in accordance with benefit coverage guidelines and department and regulatory agency standards with cost effective results.

Accountabilities:

  1. Provides supervision of the referral management and Denial staff to ensure efficient department operations which promote quality and comprehensive care for members.
  2. Participates in daily referral management and denial/appeal process activities in accordance with department standards in order to administer members' managed care benefits and promote comprehensive care.
  3. Provide leadership and direction to the designated staff of the short term case management Transition Unit of Advocate Medical Group and Advocate Physician Partners. in their positions. Ensure department standards are met, and policies and procedures are followed by associates onsite.
  4. Responsible for/oversight of telephonic utilization management for network and non-network SNF/DME/LTACH/ Transplant/Research and Clinical Referrals.
  5. Responsible for/oversight of the coordination and monitoring of discharge planning from SNF to foster efficient cost effective care and quality outcomes to members in accordance with their benefit coverage guidelines
  6. Communicates and interacts with internal and external providers and administrators in a positive, professional fashion in order to promote the delivery of quality care and effective multi-department/system function.
  7. Communication with department medical directors, Director of Medical Operations, supervisors, case managers, referral technicians, quality improvement coordinators and other health care professionals in a positive and professional fashion in order to promote member satisfaction, quality of care delivered and the integration of multi-department/system activities.


Nearest Major Market: Chicago