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)
Job Summary:
Under the direction of the Value Based Coordinator, the LPN - Managed Care, role is to provide clinical expertise for specific complex and/or rising risk patient populations with a design to meet specific contractual and program related requirements. Ensures excellence with transitions of care to achieve optimal clinical outcomes through a seamless model of access and care. Focuses on improving the health status and care for individuals with chronic conditions with complex medical, mental health and psychosocial issues. The LPN - Managed Care demonstrates knowledge and skills to appropriately communicate and interact with staff, patients, families and visitors of all age groups while being sensitive to their cultural and religious beliefs.
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