Managed Care Supervisor jobs in Irvine, CA

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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PBM / Managed Care Pharmacist
  • Pharmacy Careers
  • Irvine, CA FULL_TIME
  • We are currently seeking a skilled and motivated Pharmacist with expertise in Pharmacy Benefit Management (PBM) and Managed Care. In this pivotal role, you will be responsible for overseeing medication utilization, formulary management, and ensuring cost-effective pharmacy services. The ideal candidate will bring a deep understanding of managed care principles, a proactive approach to problem-solving, and a commitment to optimizing pharmacy outcomes within a managed care environment.

    Preferred Qualifications:
    PharmD degree from an accredited pharmacy program
    Previous experience in Pharmacy Benefit Management (PBM) or Managed Care
    Knowledge of formulary development and management
    State pharmacy license in good standing
    Strong analytical and data interpretation skills
    Excellent communication and negotiation abilities
    Familiarity with healthcare regulations and compliance standards
    Collaboration experience with healthcare providers, payers, and pharmaceutical manufacturers
    Proficiency in utilizing pharmacy management software and tools
    Active participation in relevant professional organizations
    Dedication to staying informed about industry trends and innovations

    Responsibilities:
    Collaborate with healthcare stakeholders to implement and optimize pharmacy benefit programs
    Conduct formulary reviews and assessments to ensure cost-effective and evidence-based medication choices
    Monitor and analyze pharmacy utilization trends, identifying opportunities for cost savings and improved patient outcomes
    Provide expertise in drug utilization management and prior authorization processes
    Stay informed about industry regulations, guidelines, and emerging trends in managed care pharmacy
    If you are a passionate and experienced pharmacist with a background in PBM or Managed Care, we invite you to join our dynamic team dedicated to advancing healthcare through innovative and cost-effective pharmacy solutions. Apply now to contribute to the future of managed care pharmacy.
  • 1 Month Ago

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Managed Care Biller - Centralized Billing Office (CBO)
  • Pursue Health LLC
  • Irvine, CA FULL_TIME
  • Pursue Health, LLC is a rapidly growing company that provides a full spectrum of healthcare consulting and support services to Skilled Nursing Facilities, Hospice Agencies, Out Patient Rehabilitation ...
  • 12 Days Ago

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Managed Care Pharmacist 5 - Population Health - P/T Days
  • University of California - Irvine Health
  • Orange, CA FULL_TIME
  • Updated: Apr 21, 2024 Location: Orange Job Type: Department: Population Health UC Title: PHARMACIST 5Position Number: 41083769Reports to: Admin Director Pop Hlth MgmtWorking Title: Managed Care Pharma...
  • 4 Days Ago

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Care Coordinator Supervisor
  • NEW DIRECTIONS FOR WOMEN INC
  • COASTA MESA, CA OTHER
  • Job Details Job Location: COASTA MESA, CA Position Type: Full Time Salary Range: Undisclosed DescriptionKey Areas of Responsibility: Care Coordinator Team & Operations Team Management Recruitment and ...
  • 14 Days Ago

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RN Clinical Supervisor (Home Health) - Orange County, CA
  • Neogen Care
  • Irvine, CA FULL_TIME
  • * Join Our Team of Highly Talented and Committed Clinical Professionals *This is an exciting opportunity for an upwardly achieving Registered Nurse with management and supervisory experience to take t...
  • 1 Month Ago

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LVN Nurse Supervisor / Urgent Care
  • Impact Solutions Inc
  • Mission Viejo, CA FULL_TIME
  • LVN Nurse Supervisor / Urgent CareMission Viejo, CA75-110K Full Benefits Bonus Paid Relocaton Working under the direction of the Sr. Nurse Manager and/or Site Manager/Director, this position has direc...
  • 9 Days Ago

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0 Managed Care Supervisor jobs found in Irvine, CA area

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Animal Care Supervisor
  • Petco Animal Supplies, Inc.
  • Pasadena, CA
  • Create a healthier, brighter future for pets, pet parents and people! If you want to make a real difference, create an e...
  • 4/26/2024 12:00:00 AM

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Sharp Rees Stealy- RN- Primary Care - Supervisor- Chula Vista - Full Time - Day Shift
  • Sharp Healthcare
  • Los Angeles, CA
  • Hours Shift Start Time: Variable Shift End Time: Variable Additional Shift Information: Weekend Requirements: As Needed ...
  • 4/24/2024 12:00:00 AM

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Sharp Rees Stealy - Lead RN - OB-GYN - Grossmont - Full Time- Day Shift
  • Sharp Healthcare
  • Riverside, CA
  • Hours Shift Start Time: 8 AM Shift End Time: 5 PM Additional Shift Information: Weekend Requirements: No Weekends On-Cal...
  • 4/24/2024 12:00:00 AM

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Sharp Rees Stealy - Lead RN - OB-GYN - Grossmont - Full Time- Day Shift
  • Sharp Healthcare
  • Los Angeles, CA
  • Hours Shift Start Time: 8 AM Shift End Time: 5 PM Additional Shift Information: Weekend Requirements: No Weekends On-Cal...
  • 4/24/2024 12:00:00 AM

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Customer Care Supervisor
  • Marque Urgent Care
  • Irvine, CA
  • Job Description Job Description The Customer Care Center (CCC) at Marque Urgent Care provides consistent, friendly, and ...
  • 4/23/2024 12:00:00 AM

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Sharp Rees Stealy- RN- Primary Care - Supervisor- Chula Vista - Full Time - Day Shift
  • Sharp Healthcare
  • Orange, CA
  • Hours Shift Start Time: Variable Shift End Time: Variable Additional Shift Information: Weekend Requirements: As Needed ...
  • 4/23/2024 12:00:00 AM

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Sharp Rees Stealy- RN- Primary Care - Supervisor- Chula Vista - Full Time - Day Shift
  • Sharp Healthcare
  • Riverside, CA
  • Hours Shift Start Time: Variable Shift End Time: Variable Additional Shift Information: Weekend Requirements: As Needed ...
  • 4/23/2024 12:00:00 AM

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Sharp Rees Stealy - Lead RN - OB-GYN - Grossmont - Full Time- Day Shift
  • Sharp Healthcare
  • Orange, CA
  • Hours Shift Start Time: 8 AM Shift End Time: 5 PM Additional Shift Information: Weekend Requirements: No Weekends On-Cal...
  • 4/23/2024 12:00:00 AM

Irvine (/ˈɜːrvaɪn/) is a master-planned city in Orange County, California, United States in the Los Angeles metropolitan area. The Irvine Company started developing the area in the 1960s and the city was formally incorporated on December 28, 1971. The 66-square-mile (170 km2) city had a population of 212,375 as of the 2010 census; in 2018 the California Department of Finance estimated the city's population at 276,176. A number of corporations, particularly in the technology and semiconductor sectors, have their national or international headquarters in Irvine. Irvine is also home to several hi...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Managed Care Supervisor jobs
$84,218 to $116,231
Irvine, California area prices
were up 3.0% from a year ago

Managed Care Supervisor in Austin, TX
The F/MCC Supervisor will ensure adequate team staffing, team training, participates in staff hiring and performance reviews.
December 07, 2019
Managed Care Supervisor in Lowell, MA
The individual will have a focus on assessing, interpreting, and analyzing the impact of utilization of services within the Winchester PHO to maximize performance in the managed care contracts that support the BILH Network.
February 18, 2020
Managed Care Supervisor in Montgomery, AL
The hospital offers a full range of medical services including maternity care and a Level IIB Special Care Nursery.
January 15, 2020