Pacific Medical Centers
Supervisor Care Management RN - USFHP
Pacific Medical Centers, Renton, Washington, United States, 98056
Overview
The Supervisor Care Management RN is responsible for the supervision of case management (CM) and utilization management (UM) functions of US Family Health Plan to achieve cost-effective utilization of resources. This is accomplished through the proactive coordination of services to move patients efficiently through the continuum of care and ensure referrals are reviewed and processed in a timely manner. It includes timely review of medical necessity and authorization for all admitted patients and outpatient referral requests. Responsible for ensuring accurate and consistent application of and adherence to TRICARE policy guidelines, other regulations and department policies and procedures. This position is responsible for staff schedules; oversees and supervises all areas of department operations. Works collaboratively and proactively with Director of Operations and USFHP Medical Director(s) to develop and implement strategic case management and utilization management yearly goals. Responsibilities
Supervise case management (CM) and utilization management (UM) functions to achieve cost-effective resource utilization. Coordinate services to move patients efficiently through the continuum of care; review and process referrals timely. Review medical necessity and provide authorization for all admitted patients and outpatient referrals. Ensure accurate and consistent application of TRICARE policy guidelines, other regulations, and department policies and procedures. Manage staff schedules and supervise all areas of department operations. Collaborate with the Director of Operations and USFHP Medical Director(s) to develop and implement yearly CM/UM goals. Required Qualifications
RN (Washington license) at time of hire 5 years of clinical experience Preferred Qualifications
Bachelor's Degree in Nursing Experience in acute inpatient, skilled nursing facility, home health or community health nursing including care management, care coordination, discharge planning 1 year of supervisory experience About Providence
Providence caregivers are not simply valued – they’re invaluable. Join our team at Pacmed Clinics DBA Pacific Medical Centers and thrive in our culture of patient-focused, whole-person care built on understanding, commitment, and mutual respect. Our best-in-class benefits are designed to support you and your family in staying well, growing professionally, and achieving financial security.
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The Supervisor Care Management RN is responsible for the supervision of case management (CM) and utilization management (UM) functions of US Family Health Plan to achieve cost-effective utilization of resources. This is accomplished through the proactive coordination of services to move patients efficiently through the continuum of care and ensure referrals are reviewed and processed in a timely manner. It includes timely review of medical necessity and authorization for all admitted patients and outpatient referral requests. Responsible for ensuring accurate and consistent application of and adherence to TRICARE policy guidelines, other regulations and department policies and procedures. This position is responsible for staff schedules; oversees and supervises all areas of department operations. Works collaboratively and proactively with Director of Operations and USFHP Medical Director(s) to develop and implement strategic case management and utilization management yearly goals. Responsibilities
Supervise case management (CM) and utilization management (UM) functions to achieve cost-effective resource utilization. Coordinate services to move patients efficiently through the continuum of care; review and process referrals timely. Review medical necessity and provide authorization for all admitted patients and outpatient referrals. Ensure accurate and consistent application of TRICARE policy guidelines, other regulations, and department policies and procedures. Manage staff schedules and supervise all areas of department operations. Collaborate with the Director of Operations and USFHP Medical Director(s) to develop and implement yearly CM/UM goals. Required Qualifications
RN (Washington license) at time of hire 5 years of clinical experience Preferred Qualifications
Bachelor's Degree in Nursing Experience in acute inpatient, skilled nursing facility, home health or community health nursing including care management, care coordination, discharge planning 1 year of supervisory experience About Providence
Providence caregivers are not simply valued – they’re invaluable. Join our team at Pacmed Clinics DBA Pacific Medical Centers and thrive in our culture of patient-focused, whole-person care built on understanding, commitment, and mutual respect. Our best-in-class benefits are designed to support you and your family in staying well, growing professionally, and achieving financial security.
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