Professional Care Manager, Supervisor (RN) - Community Medicine Incorporated

Purpose: The UPMC Health Plan is hiring a full-time Supervisor of Care Management (RN) to oversee a team of Clinical Care Managers in our Community Medicine Inc. offices, primarily in Downtown Pittsburgh and the South Hills.

This position is hybrid and will combine working from home with weekly travel to the Supervisor's responsible offices.

This position will work standard daylight hours, Monday through Friday.

The Supervisor is responsible for oversight and day-to-day care coordination functions for telephonic, clinical, or utilization management care management staff, including the direct supervision, coaching and counseling of staff.

Monitors staff workload, assignments, and productivity.

Assists care managers with problem solving with complicated member cases.

Acts as a resource for staff and other departments within the Health Plan.

Facilitates orientation and on boarding for clinical staff and mentors' staff in order to achieve departmental goals.

Contributes or completes performance reviews for staff.

• Ensure staff receives, understand and adhere to applicable regulatory/ compliance guidelines related to their departmental expectations (I.E. NCQA, DPW, CMS).
• Conduct regularly scheduled team and individualized meetings to communicate information, ongoing education and/or individual performance feedback.
• Serve as a resource to staff and other Health Plan departments to identify opportunities for improvements, quality of care concerns, and barriers to care coordination.
• Utilize evidence-based practice to support improvement in care / health / utilization management.
• Monitor, coach and report staff productivity and adherence to regulatory and workflow standards.
• Manage staff schedules to ensure that departmental goals are met.
• Contribute to the development, implementation and annual review of departmental policies and procedures.
• Participate in interdisciplinary treatment team meetings to facilitate the development of appropriate and comprehensive plans of care.