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)
VALLEY SPRING MEMORY CARE
Resident Care Director
GENERAL STATEMENT OF POSITION:
Under limited supervision, is responsible for all aspects of resident care including initial and ongoing assessment; hiring, training, supervising, managing and coordinating resident care including initial and ongoing assessments; hiring, training, supervising, managing and coordinating resident Care Assistants. Reports to the Executive Director.
Supervisory Responsibility:
Supervise the resident care team of the community that includes, but is not limited to, Medication Technicians and Caregivers.
Budget Responsibility:
Responsible for meeting budget goals, expenses and established care thresholds for the resident.
Essential Functions:
The following duties are normal for this position. These are not exclusive or all-inclusive. Other duties may be required and assigned: Hires and provides orientation for new Medication Technicians and Caregivers, ensuring that staffing levels are maintained; evaluates medication orders and translates them for Medication Technicians and residents as needed; supervises and evaluates Medication Technicians and Caregivers on all shifts, providing counseling and written disciplinary and/or corrective action when needed; provides in-service training for Caregivers on a routine basis and one-to-one training as needed; assesses potential residents for appropriateness prior to move-in and provides on-going written assessments of all residents; develops and maintains Care/Service Plans for each resident, updating as diagnosis/condition changes; creates and maintains resident care communication system to ensure quality care on each shift; manages electronic reporting system, occurrence and situational reporting and Medication Administration Records; monitors centrally stored medication system; manages employee uniform program; develops resident care policies and protocols as needed; communicates with physicians and families on resident’s change of condition or incident; provides first aid to residents when needed; accepts physician orders or order changes for medication or treatment, calls orders to pharmacy; assesses residents for needed medical intervention and arranges medical visits to doctor’s offices or emergency room; maintains current resident emergency records with up-to-date information; monitors the emergency call system and ensures staff responds appropriately; supervises resident meals and monitors for appropriate diets; assists with emergencies and with safety instructions for residents such as fire drills, etc.; maintains current knowledge of state and local regulations ensuring community compliance; answers telephones, assists visitors and gives tours to prospective residents; performs duties as manager on duty on a rotating basis; conducts work tasks safely and in compliance with the community safety program; provides effective and courteous service to all residents, guests and co-workers; performs other related essential duties as required; attend in-service training and workshops and meetings as required; promote and protect the rights of each resident
Supervision/Leadership
Provide high performance leadership and management of team to support the achievement of community and corporate performance goals. Observe and effectively manage the culture of the team Create an environment for team members that honors, respects and values individual opinions and suggestions; demonstrate fair treatment and ethical business practices; support development and reward achievement. Communicate performance standards to team; observe, measure and evaluate performance to ensure standards are achieved; conduct regular performance observation, assessment and discussion with team members. Communicate information that supports team and company performance and communicate reasons for decision. Ensure quality recruiting, hiring, development and retention practices that support company procedures and standards. Perform various related essential duties as required by the Executive Director. Participate in team activities and meetings. Actively build productive relationships with others. Conduct regular meetings with team members, colleagues and customers that address actions, concerns, possibilities and planning. Display ability and willingness to contribute to team by communicating effectively and consistently; follows team suggestions to maximize team performance. Engage in conversation to understand the conditions of satisfaction of job duties.
General and Organizational Requirements:
Consistently perform position responsibilities in a professional and ethical manner. Build knowledge and remain current on information, results and/or news related to the’ business that may impact revenue generation, quality of care or the business and professional relationships. Pursue job-related professional development. Monitor own work performance and adjust; seek help as needed to fulfill job duties. Understand and follow company and department policies and procedures. Understand and adhere to all laws governing team member and resident rights. Protect confidential information of team members, residents and vendors. Conduct work tasks safely and according to the community safety program. Show eagerness and flexibility completing other duties as assigned.
MINIMUM TRAINING AND EXPERIENCE:
A minimum of three years of experience in a senior living community; a minimum of three years of experience in a management/supervisory position; a bachelor’s degree in nursing or a related field may be substituted for three of the years of experience; or any equivalent combination of training and experience which provides the required skills, knowledge and abilities.
CERTIFICATION AND CLEARANCE REQUIREMENTS:
Current and valid California Nursing License (Licensed Vocational Nurse - LVN). First Aid and CPR certification.
Criminal record clearance or criminal record exemption, as required by law
Health evaluation to ensure ability to perform duties of the position and the absence of any communicable disease, including tuberculosis and CXR clearance.
Proof of COVID-19 vaccinations and boosters.
Job Type: Full-time
Pay: From $30.00 per hour
Expected hours: 40 – 60 per week
Healthcare setting:
Schedule:
Ability to Relocate:
Work Location: In person
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