Supervisor Care Coordination, RN - Northside Hospital Inc.

Northside Hospital is award-winning, state-of-the-art, and continually growing. Constantly expanding the quality and reach of our care to our patients and communities creates even more opportunity for the best healthcare professionals in Atlanta and beyond. Discover all the possibilities of a career at Northside today.

A. The Operational Supervisor Care Coordination RN is responsible for caseloads and responsible for the Care Coordination staff and units he/she supervises. Works with Care Coordinators on a daily basis to resolve complex cases and provide guidance throughout shift. Communicates and coordinates with the House Coordinator to identify care coordination actions needed to ensure effective bed management. Communicates and coordinates with Manager, Care Coordination Leadership and all other campuses as needed. In the absence of the Manager or Director, supervisor may assume responsibility. B. The UM/Appeals Supervisor Care Coordination RN is responsible for an appeals caseload and responsible for the Care Coordination staff for case reviews and UR appeals. Works with Appeals and Case review staff on a daily basis to resolve cases and provide guidance. Coordinates worklists and completion of cases on audit review, retro authorization and appeals. A. OPERATIONAL SUPERVISOR CARE COORDINATION RN: PRIMARY DUTIES AND

REQUIRED:
1. Nursing degree and three (3) years previous experience as hospital care coordinator or insurance case management. 2. Current Standards of Care & Criteria, working knowledge of Intequal and/or Milliman. 3. Ability to train and direct employees.
PREFERRED:
1. Bachelor's degree in nursing. Five years of experience in care coordination or related field. Leadership experience preferred. 2. Certification as Certified Case Manager (CCM), or Accredited Case Manager (ACM).