As a part of the Tenet and Catholic Health Initiatives family, Conifer Health brings 30 years of healthcare industry expertise to clients in more than 135 local regions nationwide. We help our clients strengthen their financial and clinical performance, serve their communities and succeed at the business of healthcare. Conifer Health helps organizations transition from volume to value-based care, enhance the consumer and patient healthcare experience and improve quality, cost and access to healthcare. Are you ready to be part of our solutions? Welcome to the company that gives you the resources and incentives to redefine healthcare services, with a competitive benefits package and leadership to take your career to the next step!
The Supervisor, CAS is responsible for:
- Supervising the work of the CAS Clinicians
- Provides daily mentoring and counseling of staff
- Ensures educational needs of staff are met.
Providing input to the CAS Director in the development and oversight of CAS processes and procedures related to the precertification solution,
Future roll out of new clients of the clinical authorization services
Include the following. Others may be assigned.
Serves as a daily resource responding to questions encompassing all aspects of the CAS processes and procedures; collaborates with internal and external customers to ensure delivery of quality service.
Monitors productivity and inventory daily to prevent backlog; implements various work list strategies to prevent backlog; takes necessary next steps to ensure Key Performance Indicator s are met.
Manages projects in conjunction with the CAS Director including but not limited to external client implementations, refinement of existing clinical service offerings to deliver exceptional value and service to customers.
Provides direct supervision of clinician FTE s and non-clinical support FTE s.
Employee management, including: Performing monthly employee scorecard reviews and discusses results on a 1:1 basis in a timely manner; manages time and attendance of each of the CAS team to ensure operational goals are consistently met; provides performance management including coaching as need arises; ensures engagement of clinicians; hires CAS team (clinical and non-clinical) in conjunction with CAS Operations Director.
Provides coverage for staff supporting inventory demands as workload dictates including new hire training as indicated.
This position carries out supervisory responsibilities in accordance with guidelines, policies and procedures and applicable laws. Supervisory responsibilities include interviewing, hiring, and training employees; planning, assigning and directing work; appraising performance; rewarding and disciplining employees; addressing complaints and resolving problems.
No. Direct Reports (incl. titles) 10-12 Revenue Cycle Clinicians
No. Indirect Reports (incl. titles) 1 5 Non-clinical support team members
KNOWLEDGE, SKILLS, ABILITIES
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
- Demonstrates proficiency in the application of medical necessity criteria, payer specific along with national standard i.e. MCG, InterQual
- Possesses excellent written, verbal and professional letter writing skills
- Demonstrates strong computer skills with multiple on line systems EMR, Email, Word, Excel, and Power Point.
- Critical thinker/anticipates and solves problems, able to make decisions regarding medical necessity independently
- Demonstrates knowledge of managed care processes.
- Ability to multi-task; effectively manages competing priorities
- Demonstrates the ability to lead a team of clinical and non-clinical professionals to attain goals
- Ability to strategically manage account volumes resulting in highest return with limited lost opportunity
- Ability to conduct on-line educational/instructional sessions
- Demonstrate strong background in customer/client services
- Ability to conduct research regarding related regulatory processes/guidelines to ensure compliance with processes related to Conifer and business unit objectives.
EDUCATION / EXPERIENCE
Include minimum education, technical training, and/or experience required to perform the job.
- Must possess a valid nursing license (Registered) Bachelor of Science in Nursing (or related field) preferred
- Minimum of 5 years recent acute care experience with the last 2 years in a facility environment; Medical-surgical/critical care experience preferred
- Minimum of 5 years recent leadership experience at supervisory level or above
- Managed care payer experience a big plus either in Utilization Review, Case Management or Appeals
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Must be able to work in sitting position, use computer and answer telephone
Includes ability to walk through hospital-based departments across broad campus settings, including Emergency Department environments
- Ability to lift and/or move up to 25 pounds
Specific vision abilities required by this job include close vision.
- Ability to travel
The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
- Office Work Environment
- Hospital Work Environment
- Approximately 25 - 50% travel may be required
- This position reports to the CAS Operations Director and is responsible for oversight of CAS Clinicians and Non-clinicians in various areas of the country.
- Valid Driver s License for state of residency
Employment practices will not be influenced or affected by an applicant’s or employee’s race, color, religion, sex (including pregnancy), national origin, age, disability, genetic information, sexual orientation, gender identity or expression, veteran status or any other legally protected status. Tenet will make reasonable accommodations for qualified individuals with disabilities unless doing so would result in an undue hardship.