Clinical Supervisor (RN) (Phoenix, AZ)

Clinical Supervisor (RN)

DIRECT HIRE OPPORTUNITY Job Summary Responsible for supervising the clinical and non-clinical staff for patients program to include the Discharge Care Coordinators Clinical Quality Team Lead and Complex Authorization Specialists. The Clinical Supervisor is responsible for all aspects of the care coordination program complex referral and authorization management and clinical quality monitoring and initiatives. This position will oversee day to day clinical operations to meet applicable contract standards. Key Responsibilities Supervises Discharge Care Coordinators Complex Authorization Specialists and Clinical Quality staff to ensure contractual standards are met. Serves as primary clinical resource for referral management discharge coordination and other clinical staff Provides clinical support and interpretation assistance to non-clinical staff for both medical surgical and behavioral health referrals and authorizations. Develops and implements enhanced systems and processes to improve operational performance metrics and delivery of care. Monitors ongoing compliance with contract standards for timeliness and quality. Collaborates with staff for data compilation and statistical analysis. Develops researches and coordinates action plans for identified potential quality issues and sentinel events Develops coordinates and integrates processes that support the clinical quality program Reviews Potential Quality Issues with the Chief Medical Officer when appropriate. Oversees the preparation of cases for the Peer Review Organization - Quality Management Committee (PRO-QMC) and monitors corrective action plans or provider intensification reviews. Key participant in Safety and Quality Committees Prepares the Clinical Quality Assurance Plan as part of the required Quality Assurance Plan Participates in cross-functional teams to enhance business strategies process improvement and use of industry best practices. Drives continuous enhancements for care coordination processes as the subject matter expert for ongoing program improvements. Performs other duties as assigned. Regular and reliable attendance is required. Competencies Communication People Skills Ability to influence or persuade others under positive or negative circumstances Adapt to different styles Listen critically Collaborate. Computer Literacy Ability to function in a multi-system Microsoft environment using Word Outlook Intranet the Internet and department software applications. Coping Flexibility Resiliency in adapting to a variety of situations and individuals while maintaining a sense of purpose and mature problem-solving approach is required. Independent Thinking Self-Initiative Critical thinkers with ability to focus on things which matter most to achieving outcomes Commitment to task to produce outcomes without direction and to find necessary resources. Information Management Ability to manage large amounts of complex information easily communicate clearly and draw sound conclusions. High Intensity Environment Ability to function in a fast-paced environment with multiple activities occurring simultaneously while maintaining focus and control of workflow. Leadership Successfully manage different styles of employees Provide clear direction and effective coaching. Multi-Tasking Time Management Prioritize and manage actions to meet changing deadlines and requirements within a high volume high stress environment. Problem Solving Analysis Ability to solve problems through systematic analysis of processes with sound judgment Has a realistic understanding of relevant issues. Technical Skills Thorough knowledge of health care delivery clinical quality assurance program development and metrics managed care concepts management reporting tools and medical management systems ability to perform critical in-depth analysis of medical records for appropriateness and effectiveness of referral activities Benefits Comprehensive and progressive benefits package that includes Medical dental and vision coverage Generous paid time off 401(k) Retirement Savings Plan (with matching) Short-term and long-term disability basic life and accidental death and dismemberment insurance Equal employment opportunity employer. Applicants are considered for positions without discrimination on the basis of race color religion sex sexual orientation gender identity national origin age disability or any other consideration made unlawful by applicable federal state or local laws. EDUCATION & EXPERIENCE Required o Registered Nurse with current unrestricted license o 2 years of supervisory or managerial experience o 5 years clinical experience o Managed care and operational experience in medical management systems including referral management prior authorization care coordination clinical quality or utilization management Preferred o 2 years experience in a production environment o Bachelor s Degree in Nursing Health Administration or related field