Managed Care Supervisor supervises and coordinates activities of personnel in the managed care operations department of a healthcare facility. Oversees staff that process referrals, authorizations, billing, utilization review, and capitation for hospital services. Being a Managed Care Supervisor experienced in utilization review techniques and protocols. Requires a bachelor's degree. Additionally, Managed Care Supervisor typically reports to a manager or head of a unit/department. May require Registered Nurse (RN). Makes day-to-day decisions within or for a group/small department. Has some authority for personnel actions. The Managed Care Supervisor supervises a group of primarily para-professional level staffs. May also be a level above a supervisor within high volume administrative/ production environments. To be a Managed Care Supervisor typically requires 3-5 years experience in the related area as an individual contributor. Thorough knowledge of functional area and department processes. (Copyright 2024 Salary.com)
Join an award-winning team of dedicated professionals committed to our core values of quality, compassion and community! Desert Valley Medical Group is affiliated with Desert Valley Hospital, one of the nation’s “100 Top Hospitals” and “A” rated for patient safety. We offer incredible opportunities to expand your horizons and be part of a community dedicated to making a difference.
We are an Equal Opportunity Employer and do not discriminate against applicants due to veteran status, disability, race, gender, gender identity, sexual orientation, or other protected characteristics. If you need special accommodation for the application process, please contact Human Resources. Know Your Rights: https://www.eeoc.gov/sites/default/files/2022-10/EEOC_KnowYourRights_screen_reader_10_20.pdf
Responsible for processing assigned outside provider referrals as well as obtain authorizations for testing in house. Assures timely submissions of authorizations to patients and providers. Maintaining quality care and cost containment per health plan and DVMG. Interacts with all members of the hospital staff, medical staff, patient’s family/significant other and community agencies in providing comprehensive care.
EDUCATION, EXPERIENCE, TRAINING
1. High School graduate or GED
2. Managed care experience and possess knowledge of health plan requirements
3. Basic knowledge of Microsoft Word, Excel and Access
Desert Valley Medical Group offers competitive compensation and a comprehensive benefits package that provides employees the flexibility to tailor benefits according to their individual needs. Our Total Rewards package includes, but is not limited to, paid time off, a 401K retirement plan, medical, dental, and vision coverage, tuition reimbursement, and many more voluntary benefit options. A reasonable compensation estimate for this role, which includes estimated wages, benefits, and other forms of compensation, is $17.15 to $22.98. The exact starting compensation to be offered will be determined at the time of selecting an applicant for hire, in which a wide range of factors will be considered, including but not limited to, skillset, years of applicable experience, education, credentials and licensure.
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