Supervisor – Inpatient Case Management (San Diego)
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Job Location:
California, CA - USA
Yearly Salary:
$ 91640 - 117605
Posted on:
Yesterday
Vacancies:
1 Vacancy
Job Summary
About the Role:
The Supervisor Inpatient Case Management is responsible for leading and overseeing the daily operations of the inpatient case management team in the San Diego market. This role ensures timely compliant and high-quality utilization management care coordination and documentation while serving as a clinical and operational resource to staff providers and Medical Directors. The Supervisor plays a key role in driving consistency productivity and alignment with Astrana Health policies payer requirements and regulatory standards.
The Supervisor Inpatient Case Management is responsible for leading and overseeing the daily operations of the inpatient case management team in the San Diego market. This role ensures timely compliant and high-quality utilization management care coordination and documentation while serving as a clinical and operational resource to staff providers and Medical Directors. The Supervisor plays a key role in driving consistency productivity and alignment with Astrana Health policies payer requirements and regulatory standards.
What Youll Do
- Provide day-to-day supervision coaching and support to inpatient case managers
- Ensure timely completion of utilization review authorizations and documentation in accordance with policy and payer requirements
- Monitor team productivity quality and compliance with established workflows and turnaround times
- Serve as a clinical resource for complex cases transfers denials and medical necessity reviews
- Collaborate daily with Medical Directors hospitalists and facility partners regarding bed days level of care and skilled admissions
- Escalate and help resolve barriers to care discharge delays and provider issues
- Support auditing reporting and continuous improvement initiatives related to quality and performance
- Assist with onboarding training and development of inpatient case management staff
- Ensure appropriate use of benefit guidelines contracted providers and payer rules
- Promote a culture of accountability teamwork and high-quality member care
- Miscellaneous responsibilities as directed by leadership
Qualifications
- Active unrestricted RN license (required)
- Minimum 35 years of inpatient case management or utilization management experience
- Prior supervisory or lead experience strongly preferred
- Strong working knowledge of medical necessity criteria benefit guidelines and payer requirements
- Experience collaborating with physicians hospitalists and Medical Directors
- Ability to interpret clinical documentation and apply appropriate level-of-care determinations
- Strong organizational communication and problem-solving skills
- Comfortable managing performance productivity and quality metrics
- Proficient with case management systems and electronic medical records
- Ability to work in a fast-paced high-accountability environment
- Other duties as assigned
Environmental Job Requirements and Working Conditions
- This is mostly a remote position. The home office is located at 600 City Parkway West Orange County CA 92868.
- This position does require traveling to partnered hospitals located in San Diego CA. Staff should be flexible traveling based on business needs.
- The national target pay range for this role is $91640.44 - $117605.23. Actual compensation will be determined based on geographic location (current or future) experience and other job-related factors.
Astrana Health is proud to be an Equal Employment Opportunity and Affirmative Action employer. We do not discriminate based upon race religion color national origin gender (including pregnancy childbirth or related medical conditions) sexual orientation gender identity gender expression age status as a protected veteran status as an individual with a disability or other applicable legally protected characteristics. All employment is decided on the basis of qualifications merit and business need. If you require assistance in applying for open positions due to a disability please email us at to request an accommodation.
Additional Information:
The job description does not constitute an employment agreement between the employer and employee and is subject to change by the employer as the needs of the employer and requirements of the job change.
Required Experience:
Manager
Key Skills
- Environment
- J2se
- Catering
- ESI
- Actuary
