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Supervisor, Care Connector Utilization

North Shore-LIJ Health System


Location:
Nassau, NY
Date:
08/21/2017
2017-08-212017-09-20
Job Code:
1668641
Categories:
  • Administrative / Clerical
  • Healthcare
North Shore-LIJ Health System
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Job Details

Job Title: Supervisor, Care Connector Utilization
Job Number: 0011N4

Description

As a Utilization Review Supervisor you will supervise and coordinate the work activities of Utilization Review for North Shore-LIJ CareConnect. Review, interpret and/or develop and recommend policies and procedures pertaining to utilization. Ensures all utilization reports, statistics and materials are compliant, timely prepared and accurately maintained. Coordinate activities in accordance with standards of state and federal regulations; and in accordance with accreditation and other guidelines.


  • Works with staff to maintain flow and quality of work. Ensures timely accomplishment of work and adherence to standards of quality. Provides critical intervention and strategic planning around problem cases.

  • Supervises staff, coordinates scheduling, and sets guidelines for employee orientation. Hires, trains, disciplines and evaluates job performance.

  • Confers with professional, administrative, medical and managerial staff with retard to resolution of issues. Acts as a resource person for staff in problem solving.

  • Ensures all utilization reports, statistics and materials are compliant, timely prepared and accurately maintained.

  • Performs medical necessity reviews for selected procedures and services.

  • Provides timely and thorough case screening to identify case management needs and make appropriate referrals to case managers.

  • Collaborates with members/designees, families and members of the health care team to maximize outcomes.

  • Identifies discharge needs and collaborates with health care providers to facilitate a timely discharge to an appropriate level and location of care.

  • Educates providers and members to promote self-care and self-advocacy.

  • Realizes positive outcomes in terms of the quality, safety and cost-effectiveness of health care services provided.

  • Develops and maintains cooperative relationships with other parts of the organization. Consults with colleagues/experts as needed.

  
        



Qualifications
        • Bachelor’s Degree in Nursing, required.
        • Current license to practice as a Registered Professional Nurse in New York State.
        • Minimum of five (5) years clinical experience, required. Previous experience in case management, disease management, quality management or patient education, preferred.

Our Culture:

Transforming care, optimizing patient satisfaction and creating better patient outcomes are just some of the things our talented team members are doing at North Shore-LIJ each and every day. As a culture committed to providing our customers with the highest quality service, we stand behind our core values: Patients first; Caring; Excellence; Innovation; Integrity and Teamwork. It is our commitment and our culture that sets us apart from others and is the cornerstone of everything we do. Join an organization whose team members are valued, cared for and offered continuous opportunities to grow. Click on the link to learn more about us: www.northshorelij.com/goals

Please note: North Shore-LIJ is a smoke-free environment. Smoking and the use of tobacco products is strictly prohibited anywhere on campus, including parking lots and outdoor areas on the premises. Free smoking cessation programs and quit medications are offered to team members who wish to quit through the North Shore-LIJ Center for Tobacco Control.


Job Management

Primary Location Nassau County-Greenvale-2200 Northern Boulevard

Schedule Full Time

Shift Day Job

Shift Detail 

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