Clinical Supervisor - PAC - UM - IRF/LTAC

It has been brought to our attention that there have been instances of fraudulent job postings and job offers that appear to come from CareCentrix. Recruitment fraud is a sophisticated scam offering fake job opportunities to job seekers and is often accompanied by requests for sensitive personal and financial information including, but not limited to, requests for payment for equipment as a condition of employment. CareCentrix does not require or collect money, credit card, or bank account information from applicants or candidates as a condition of employment. If you have any questions or need to report a potential concern, please contact our recruiting team at TalentAcquisition@carecentrix.com. CareCentrix is committed to making the home the center of patient care. We have more than 20 years of experience working with payors and providers to create programs that improve quality and lower costs by allowing patients to heal or age where they want to be: at home. We currently manage care for 26 million members through over 8,000 provider locations. Through advanced analytics, we determine the appropriate site for post-acute care, and provide support and coordination for patients and their families throughout care transitions, including to and from Skilled Nursing Facilities (SNFs) and through Home Health, Home DME, Home Infusion, and Home Sleep services.

The Post-Acute Care Program assists with reducing hospital readmissions of clinically complex patients. The program couples patient education/coaching with Home Health interventions to assist a patient’s transition home after a hospital stay. Staff works directly with patients in transitioning from hospital to home with a focus on short term self-recovery in the home and long term ongoing care management of their healthcare. Assess patients care needs through assessments that are completed in home and/or telephonically, treatment plan creation to mitigate care gaps, facilitate in home health care services to accomplish the treatment plan patient goals, patient education/coaching along with adherence/compliance monitoring. This position functions as the Supervisor of the Post-Acute Care team and primary point of contact for day to day clinical questions, concerns from internal and external clients and provides team leadership and guidance regarding patient centered interventions. Assists in development of Post-Acute Care training, job aids and tools and desk level procedures. Provides clinical oversight for nurses.

Supervise the Post-Acute Care team members (clinical), provides team leadership and guidance regarding patient centered interventions and oversees daily workload and makes assignments to ensure timely completion as needed. Function as lead clinical resource to all associates. Supports the management team with training, tools and clinical oversight for both clinical team members. Supervise all daily team activities, assigns tasks and responsibilities to appropriate team members. Monitors performance and productivity of team and individual members and takes appropriate action to ensure guidelines and goals of the department are met. Complete performance reviews and mentors the Post-Acute Care team members. Function as the lead clinical resource to Post-Acute Care team. Supports auditing Post-Acute Care cases and interventions to monitor outcomes, track/trend results and identify opportunities for process improvement. Work collaboratively with Provider Relations and provider network department to achieve desired goals. Work with the Clinical Management to implement best practices for care transitions, utilization and authorization management of selected home care services. Work with Clinical Management to support clinical and utilization management goals and objectives. Participate in special projects and performs other duties as assigned. Perform other duties as required or assigned. This is the job for you if: You have previous management / leadership experience strongly desired but not required. Licensed professionals are required to possess a current license to practice without restrictions. You possess knowledge of State and Federal regulations in regard to Utilization Management and accreditation standards i.e. URAC, NCQA required. You possess excellent writing, organization, communication, and interpersonal skills. You are able to manage multiple tasks, be detail oriented, be responsive, and demonstrate independent thought and critical thinking. You have excellent clinical knowledge and ability to lead and guide others to be successful.