Role Overview:
Responsible for overseeing the NV Medical Management Command Center RN case management functions, including discharge planning, transitions of care, and utilization management for long-term hospitalized members.
Ensures effective daily operations, documentation oversight, and RN decision safety at discharge. Leads IDT meetings, participates in taskforces, and manages performance metrics.
Focuses on team development, training, and support to meet compliance and customer service standards, fostering high morale and productivity. Promotes collaboration across departments and utilizes LEAN principles for performance improvement.
Manages workflows, develops work and educational plans, and reports progress to leadership.
Qualifications & Skills:
Active Nevada RN license, with CCM certification within 2+ years, and at least 1+ years of managed care and supervisory experience. Strong clinical, regulatory, and technology knowledge. Excellent interpersonal, negotiation, and critical thinking skills. A bachelor’s degree is preferred.
The role involves working in hospital or office settings and driving as needed. Key competencies include project participation, metric-driven performance, and team leadership.