Supervisor III

Company:Concentra Location:Woodbridge, NJ 07095 Job Category:Quality Assurance/Safety Reference Code:conc-00018571 Serving the occupational, auto and group healthcare markets, Concentra provides employers, insurers and payors with a series of integrated services that include employment-related injury and occupational healthcare, in-network and out-of-network medical claims review and repricing, access to preferred provider organizations, first notice of loss services, case management and other cost containment services. Concentra provides its services to approximately 136,000 employer locations and 3,700 insurance companies, group health plans, third-party administrators and other healthcare payors. The Company has over 300 medical centers located in 40 states. It also operates the Beech Street and FOCUS networks which include 544,000 providers, 52,000 ancillary providers and 4,400 acute-care hospitals nationwide. Concentra is an Equal Opportunity Employer.NOTICE:Employment Verification Done. Federal law requires all employers to verify the identity and employment eligibility of all persons hired to work in the United States. JOB SUMMARY: Monitors the activity of the case management staff for timeliness and provides assistance as needed. MAJOR DUTIES AND RESPONSIBILITIES:People Management:' Provides coverage for the case managers as needed.' Oversee the distribution of new referrals.' Oversees and drives to departmental goals in precertification processing, HRE completion, IME referrals, appropriate closures and optimal telephonic customer service.' Interacts with providers and insured concerning claim problems and issues regarding the case managers.' Interfaces with account representatives to insure open line of communication regarding the NCM process.' Responsible for time and attendance and approval of scheduled time off.' Performance evaluations of all staff.' Provides direction with problem identification, problem solving, and development of new processes as needed.' Quality Assurance calibration, best practice to direct reports performance.' Assurances compliance with State regulatory statutes and URAC Standards.' Assures case management services are provided with in CSMA Standards of Care.Process Management:' Provides direct supervision and training of the telephonic case managers.' Provide statistics on direct reports status daily.' Ensures smooth workflow processes among the Telephonic Case Managers and other AIS departments.' Provides direction with problem identification, problem solving and development of new processes as needed.' Assures case management services are provided within CSMA Standards of Care.' Assures compliance with State regulatory statutes and URAC Standards.' Provides coverage for the case managers as needed. QUALIFICATIONS:' Registered Nurse ' Licensed in New Jersey' Minimum 5 years clinical experience' Prior supervisory or management experience in health care or insurance environment' Minimum 1year experience as a Case Manager in a managed care or insurance environment.' Strong problem solving, critical thinking and interpersonal skills.' Computer literate.' Excellent verbal and written communication skills. To Apply, Click here The Circle of Success.Concentra's mission is to improve the quality of life by making health care accessible and affordable. We serve the occupational, urgent care, and automobile markets with a wide range of services: Employment-related injury care and occupational health care provided at more than 320 Concentra-managed medical centers in 40 states. Urgent care services provided to the public at selected medical center locations in key metropolitan areas. Specialty occupational health care solutions provided to employers through on-site locations, by traveling to the workplace, or via the Internet and telephone. Automobile claim services through our Auto Injury Solutions division. The Circle of Opportunity. Concentra manages more than 320 medical centers in 40 states and continues to expand our geographic reach through the acquisition of established medical providers and the development of new locations. We are actively expanding our Urgent Care service offering by adding this capability to existing Concentra Medical Center locations. Our specialty health services, which we refer to as our Health Solutions division, is rapidly expanding as we identify new ways to provide customized health care solutions for employers and their workers.The Circle of Teamwork. Concentra brings together talented, compassionate people to solve the highly complex issues of health care delivery, accessibility, and affordability. Every day, we make a difference in the lives of thousands of people through our ability to improve health care efficiency and outcomes. Your career path and development can be on-the-go at Concentra, where you can advance as far as your ideas and performance can take you.