Managed Care Supervisor jobs in Idaho

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)

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Managed care
  • Pennant Group
  • Eagle, ID FULL_TIME
  • JOB SUMMARY

    The Managed Care Resource will support our Home Health, Hospice, Private Duty and Senior Living Facility leaders in managed care contracting and revenue enhancement strategies for all healthcare payers as well as assist in the preparation for changes in the healthcare industry.

    The Consultant will negotiate managed care payer contract rates and terms and provide guidance with regards to the development of managed care relationships, ensuring timeliness and appropriateness of negotiated rates.

    Additionally, the Resource will negotiate contracts for new locations, assist with ensuring that contracts are updated for new services and help with contract cancellations, denials, appeals and high level contract payment disputes.

    DUTIES & RESPONSIBILITIES

    Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

    • Establish, plan, direct and evaluate the implementation of tactical plan(s) that will ensure expansion and support of business operations into managed care relationships and brings consistency of contract-related criteria and guidelines to optimize financial performance and minimize risk for operations.
    • Assist in analysis of contract terms and rates and coordinating the submission of amendments, changes in reimbursement, language changes and assist in advising each operation of risks and advantages of signing contracts.
    • Identify, develop and maintain an effective relationship with managed care payors and managed care / health care regulatory agencies.
    • Provide guidance and training when applicable to assist Field Operations partners in order to assist in accelerating the results of the Field.
    • Monitor industry changes, market trends and events to proactively identify opportunities to increase and protect the operations managed care revenue as well as present as subject matter expert with regards to applicable changes in the healthcare industry.
    • Coordinate and assist each operation with any issues such as contract cancellation and denials / appeals.
    • Effectively communicate at all organizational levels and in situations requiring education, consultation, instruction, persuasion, negotiation and advisement as Consultant will serve as internal managed care subject matter expert to Presidents, Executive Directors and Service Center leadership personnel.
    • Teach, train and advise operational leadership on how to administer their managed care contracts by the creation and distributions of tools, training and resources for leadership, AR team, Intake personnel, Case Management and all other Operations or Service Center team members as needed.
    • Assist AR team with high level managed care claims issues and projects to ensure timely collection of monies due.
    • Serve as primary liaison for all operations by distributing to operations and service center all key contract terms and rates for all new and existing managed care payer contracts.

    JOB REQUIREMENTS (Education, Experience, Knowledge, Skills & Abilities)

    • Bachelor’s degree in business administration, management or health care administration preferred.
    • 5 years’ experience in managed care contracting with a managed care payer or provider organization.
    • Analytically oriented with the ability to communicate complex financial matters in a concise, professional manner.
    • Must be knowledgeable about the managed care environment; including Medicare Advantage, Commercial and Managed Medicaid products (HMO, PPO, EPO, POS and Special Needs Plans) as well as knowledge of Accountable Care Organizations (ACO’s).
    • Work collaboratively as part of the Managed Care Team.
    • Knowledge of managed care payer contract language and terms, standard requirements and negotiated rate methodology to support contract compliance and analysis.
    • Must be able to prioritize, plan, and handle multiple tasks / demands simultaneously and have strong analytical and problem solving skills with keen attention to detail and an aptitude for accuracy.
    • Excellent verbal and written communication skills, as well as excellent critical thinking skills.
    • Maintain confidentiality and comply with Health Insurance Portability and Accountability Act (HIPAA).
    • Knowledge of Home Health, Hospice, Private Duty and Assisted Living Facility operations is a plus.
    • Ability to be flexible, adaptable, and work in a rapidly and constantly changing environment
    • Knowledge of CPT-4, HCPCS, Revenue and ICD coding.
    • Strong computer skills (MS Word, MS Outlook & Excel) with Smartsheet knowledge a plus.
    • Must be able to travel.

    Please note this job description has been designed to indicate the general nature, working conditions and level of work performed by employees within this job.

    It is not designed to contain or be interpreted as a comprehensive inventory of all duties, responsibilities, working conditions and qualifications required of employees assigned to this job.

    Duties, responsibilities and activities may change at any time with or without notice. Additionally, the incumbent may be requested to perform job-related tasks other than those stated in this description.

    Last updated : 2024-03-09

  • 14 Days Ago

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Lawn Care Supervisor
  • Clean Cut Lawn Care
  • Idaho Falls, ID FULL_TIME
  • Are you being appreciated for your hard work? Are you wanting a position that you get the training and support to become an expert in your field? Do you want to be part of a company that cares for you...
  • 3 Days Ago

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Case supervisor
  • Family Resource Home Care
  • Boise, ID FULL_TIME
  • Family Resource Home Care is a leading home care agency dedicated to providing high-quality, compassionate care to our clients in their homes. We specialize in personalized in-home care to help our cl...
  • 1 Month Ago

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Direct Care Staff Supervisor
  • Foster & Heart
  • Meridian, ID FULL_TIME
  • Direct Care Staff Supervisor Foster Heart is a nonprofit 501(c)3 organization serving the Treasure Valley. Our mission is to ignite the hearts of our community to foster and meet the needs of children...
  • 4 Days Ago

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Calf Care Supervisor
  • Cedar Ridge Dairy
  • Twin Falls, ID FULL_TIME
  • Job Title: Calf Care Supervisor Company: Cedar Ridge Dairy Location: Twin Falls, Idaho Are you passionate about animal care and looking for a rewarding role in animal agriculture? Cedar Ridge Dairy is...
  • 1 Month Ago

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Activities Supervisor/Medical Records Clerk
  • Lincoln County Care Center
  • Shoshone, ID FULL_TIME
  • Hello, Lincoln County Care Center in Shoshone, ID is actively looking to hire a Charismatic full-time Activities Director/Medical Records Clerk. At Lincoln County, our goal in a skilled nursing facili...
  • 2 Days Ago

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Nutrition Care Supervisor
  • HumanGood
  • Jenkintown, PA
  • Rydal Park & Waters, a premier Life Plan Community located in Jenkintown, is hiring a Nutrition Care Supervisor to join ...
  • 3/28/2024 12:00:00 AM

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Client Care Supervisor
  • Family Resource Home Care
  • Bellingham, WA
  • Family Resource Home Care is a leading home care agency dedicated to providing high-quality, compassionate care to our c...
  • 3/28/2024 12:00:00 AM

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Animal Care Supervisor
  • VCA Animal Hospitals
  • Boca Raton, FL
  • We are seeking a highly experienced Animal Care Professional to join our leadership team as Animal Care Supervisor. The ...
  • 3/28/2024 12:00:00 AM

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Animal Care Supervisor
  • Petco Animal Supplies Inc
  • Pompano Beach, FL
  • Create a healthier, brighter future for pets, pet parents and people! If you want to make a real difference, create an e...
  • 3/28/2024 12:00:00 AM

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Customer Care Supervisor
  • PLS Financial Services, Inc.
  • Oak Brook, IL
  • Overview: PLS: People. Location. Service PLSwhich stands for People Location - Serviceis a leading retail provider of al...
  • 3/27/2024 12:00:00 AM

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Animal Care Supervisor
  • Petco Animal Supplies, Inc.
  • Milltown, NJ
  • Create a healthier, brighter future for pets, pet parents and people! If you want to make a real difference, create an e...
  • 3/27/2024 12:00:00 AM

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Animal Care Supervisor
  • Petco Animal Supplies Inc
  • Milltown, NJ
  • Create a healthier, brighter future for pets, pet parents and people! If you want to make a real difference, create an e...
  • 3/25/2024 12:00:00 AM

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Respiratory Care Supervisor
  • Essentia Health
  • Detroit Lakes, MN
  • Job Description: In this position you will provide support for the development and implementation of strategic and opera...
  • 3/14/2024 12:00:00 AM

Idaho (/ˈaɪdəhoʊ/ (listen)) is a state in the northwestern region of the United States. It borders the state of Montana to the east and northeast, Wyoming to the east, Nevada and Utah to the south, and Washington and Oregon to the west. To the north, it shares a small portion of the Canadian border with the province of British Columbia. With a population of approximately 1.7 million and an area of 83,569 square miles (216,440 km2), Idaho is the 14th largest, the 12th least populous and the 7th least densely populated of the 50 U.S. states. The state's capital and largest city is Boise. Idaho p...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Managed Care Supervisor jobs
$71,040 to $98,046

Managed Care Supervisor in Columbia, SC
The Supervisor Business Services of Government Billing and Collections will be responsible for the overall AR management of all government inventory.
January 02, 2020
Managed Care Supervisor in Colorado Springs, CO
In Service to Our Community is achieved through streamlined, coordinated and comprehensive high-quality, compassionate care close to home.
February 15, 2020
Managed Care Supervisor in Portland, ME
·        Minimum one year resolving claims issues with Payer Relations representatives to handle managed care contract implications.
February 19, 2020