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ProMedica Health System RN / Registered Nurse - Elite Case Manager Team Lead - Full Time - Days in Maumee, Ohio

Thank you for inquiring about a position with Paramount. We are a NCQA accredited managed care plan, which is part of ProMedica’s integrated healthcare system with offices in Maumee, Columbus, Cleveland, and Cincinnati. Paramount provides health insurance coverage for Medicare, Medicaid, and Commercial members. For more information about Paramount, please visit our website http://www.paramounthealthcare.com

Our mission is to improve your health and well-being. So we’re committed to your wellness with various initiatives, such as preventive services, online knowledge, health risk assessments, our Steps2Health disease management programs, health fairs, and more.

The Paramount Elite Case Management Team Lead is a working team leader who serves as a clinical resource and is responsible for staff supervision and the day-to-day operations of case management. The team leader acts as an interdepartmental liaison to ensure prompt resolution of case management issues, questions, and concerns. The Case Management Coordinators report directly to this position.

  • Serve as departmental resource/educator/decision maker for case management processes using the Utilization/Case Management Program description, nursing education and experience.

  • Ensure that regulatory and accreditation requirements for case management are met.

  • Assist in development and update of policies and procedures for case management activities.

  • Supervise Case Management Coordinators to ensure that all plan personnel policies are consistently administered through systematic quarterly feedback and annual performance appraisals along with documented counseling/disciplinary procedures, when necessary.

  • Monitor potential high-dollar cases and collaborate with the Finance Department on case-specific expected risks.

  • Prepare monthly report for Manager/Director, Utilization/Case Management outlining case management activities, including actual vs. expected performance, potential problem areas and opportunities for improvement.

  • Maintain a reduced case management caseload as a working team leader.

  • Must have ability to travel within the state of Ohio for provider and delegate relationship-building.

  • Perform other duties as directed.

  • Current Ohio registered nurses license required.

  • Certification in case management preferred

  • 2 years of leadership preferred

  • Minimum 2-3 years recent clinical experience and 1 year case management experience with an HMO preferred

  • Excellent communication (oral and written) and organizational skills required. Ability to plan, coordinate and organize multiple priorities & exercise independent judgment.

  • Demonstrated PC skills, including word processing/spreadsheet/database and graphics applications strongly preferred.

  • Ability to move between company work stations and departments; ability to communicate on telephones and operate general office equipment, including computers.

  • Valid driver’s license, reliable vehicle with proof of auto insurance.

ProMedica is a mission-based, not-for-profit integrated healthcare organization headquartered in Toledo, Ohio. For more information, please visit www.promedica.org/about-promedica

Qualified applicants will receive consideration for employment without regard to race, color, national origin, ancestry, religion, sex/gender (including pregnancy), sexual orientation, gender identity or gender expression, age, physical or mental disability, military or protected veteran status, citizenship, familial or marital status, genetics, or any other legally protected category. In compliance with the Americans with Disabilities Act Amendment Act (ADAAA), if you have a disability and would like to request an accommodation in order to apply for a job with ProMedica, please contact employment@promedica.org

Equal Opportunity Employer/Drug-Free Workplace

Requisition ID: 55346

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