Supervisor of Case Management

Medix provides workforce solutions to clients and creates opportunity for contract employees representing a variety of industries through our Healthcare, Scientific and Information Technology divisions.

Ensures the Care Management Department achieves required service standards by measuring team performance against goals/metrics, directs the flow of work, and identifies opportunities for process improvements.

• Supervise the day-to-day activities of a unit of employees engaged in medical management activities.
• Perform, evaluate, and assist in defining and improving the quality, quantity and timeliness standards to achieve individual and department performance goals as defined within the department guidelines.
• Keep status of the unit current in accordance with metrics, systems, procedures, forms and manuals through staff meetings and verbal and written communications.
• Monitor and investigate computer system issues.
• Assist with analysis of medical records and application of medical necessity criteria and benefit plan requirements to determine the appropriateness of benefit requests and level of care.
• Assist in the preparation and analysis of cost/benefit and outcomes reports.
• Participate in the activities necessary for preparation and submission of all URAC materials for the accreditation process.

• 3 year(s) of experience in clinical field of practice, health insurance, or other health care related field
• 2 years of experience in full-time equivalent of direct clinical care to the consumer
• Active, current, and unrestricted license to practice in the State of Arizona (a State in the United States) as a Registered Nurse (RN)