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)
This is a casual, grant funded position with an end date of 06/30/26
JOB SUMMARY:
The Enhanced Care Management (ECM) Supervisor manages the daily operations of the satellite ECM Program which includes but is not limited to patient access to ECM services, case identification
and prioritization, patient triage, case assignments to staff, managing referrals, monitoring staff productivity and caseload, identifying community resources, conducting staff performance
evaluations, recruiting and hiring of staff, managing performance and implementing disciplinary action. Provides leadership to the satellite ECM and provides support and consultation to the main
ECM Program staff. Participates in interdisciplinary case conferencing care planning. Facilitates and ensures that all ECM members receive all ECM core service components. Collaborates with the
ECM RN Manager and ECM Director on ECM operations, quality initiatives, and program development. Attends meetings at RCHSD and the community as assigned. Ensures compliance with all health plan deliverables and contractual obligations as well as regulatory agency requirements.
MINIMUM QUALIFICATIONS:
Master's Degree
3 Years of Experience
Medical Social Worker, Licensed Social Worker or Marriage and Family Therapist
The expected hiring range for this position is $41.49 to $57.05
Rady Children’s Hospital is committed to compensation that is externally competitive and internally equitable. We demonstrate this commitment by conducting regular market reviews to remain competitive with organizations of similar size in the nonprofit, healthcare sector. The range listed above does not represent the full salary range for the position but is the expected hiring range for qualified candidates. Compensation decisions consider a variety of factors including experience, education, licensure, unique skillsets, organizational need, and internal equity. This posting will remain open from the “date posted” until the hiring manager has determined there is a sufficient applicant pool or until the position is filled.
Clear All
0 Managed Care Supervisor jobs found in Corona, CA area