Managed Care Supervisor jobs in Wisconsin
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)
Recently Added Managed Care Supervisor jobs
RN Care Manager
- Managed Health Services Wisconsin
-
Racine, WI
FULL_TIME
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You could be the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective on workplace flexibility.
* We are currently offering a $5,000 sign-on bonus for this position *
** This hybrid remote role requires less than 50% travel in Milwaukee / Appleton area and candidates will have the flexibility to work remotely from their home the remaining time **
Position Purpose: Perform care management duties to assess, plan and coordinate all aspects of medical and supporting services across the continuum of care for select members to promote quality, cost effective care.
• Assess the member's current health status, resource utilization, past and present treatment plan and services, prognosis, short and long term goals, treatment and provider options
• Utilize assessment skills and discretionary judgment to develop plan of care based upon assessment with specific objectives, goals and interventions designed to meet member's needs and promote desired outcomes
• Coordinate services between Primary Care Physician (PCP), specialists, medical providers, and non-medical staff as necessary to meet the complete medical socio economic needs of clients
• Provide patient and provider education
• Facilitate member access to community based services
• Monitor referrals made to community based organizations, medical care and other services to support the members’ overall care management plan
• Actively participate in integrated team care management rounds
• Identify related risk management quality concerns and report these scenarios to the appropriate resources.
• Case load will reflect heavier weighting of complex cases than Care Manager I, commensurate with experience
• Enter and maintain assessments, authorizations, and pertinent clinical information into various medical management systems
• Direct care to participating network providers
• Perform duties independently, demonstrating advanced understanding of complex care management principles.
• Participate in case management committees and work on special projects related to case management as needed
Education/Experience: Graduate from an Accredited School of Nursing. Bachelor’s degree in Nursing preferred. 2 years of clinical nursing experience in a clinical, acute care, or community setting and 1 years of case management experience in a managed care setting. Knowledge of utilization management principles and healthcare managed care. Experience with medical decision support tools (i.e. Interqual, NCCN) and government sponsored managed care programs.Licenses/Certifications: Current state’s RN license and a valid driver's license
Pay Range: $66,100.00 - $118,900.00 per year
Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law. Total compensation may also include additional forms of incentives.
Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.
About the Company:
Managed Health Services Wisconsin
- 1 Month Ago
RN Care Manager
- Managed Health Services Wisconsin
-
Carlton, WI
FULL_TIME
- You could be the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offeri...
- 1 Month Ago
RN Care Manager
- Managed Health Services Wisconsin
-
Nelson, WI
FULL_TIME
- You could be the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offeri...
- 1 Month Ago
Care Manager II (RN) - Now Hiring
- Managed Health Services WI
-
Kansasville, WI
FULL_TIME
- You could be the one who changes everything for our 26 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offeri...
- 8 Days Ago
MANAGED CARE CONTRACT COORD, FCH - MANAGED CARE
- Froedtert Health
-
Menomonee Falls, WI
FULL_TIME
- Discover. Achieve. Succeed. #BeHere Location: US:WI:MENOMONEE FALLS at our WOODLAND PRIME 400 facility. This job is HYBRID.FTE: 1.000000Shift: 1st shift 8 am to 4:30 pm onsite Tuesday and Wednesday th...
- 1 Month Ago
Managed Care Coordinator
- Family Health Center of M
-
Ladysmith, WI
FULL_TIME
- The Managed Care Coordinator completes insurance requirements and provides case management as needed for services performed in various patient seeing settings. The individual obtains and provides insu...
- 12 Days Ago
Managed Care Supervisor jobs at Popular Companies
Care Supervisor
- Help At Home
-
Natchez, MS
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Care Supervisor
- Help At Home
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Starkville, MS
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Care Supervisor
- Help At Home
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Warren, PA
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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...
- 4/26/2024 12:00:00 AM
Animal Care Supervisor
- Petco Animal Supplies, Inc.
-
Dayville, CT
- 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
Care Supervisor
- Help at Home
-
Natchez, MS
- Help at Home is hiring a Care Supervisor! Offering weekly pay! Help at Home, LLC is the nation’s leading provider of hig...
- 4/23/2024 12:00:00 AM
Care Supervisor
- Help at Home
-
Starkville, MS
- Help at Home is hiring a Care Supervisor! Now offering weekly pay! Help at Home, LLC is the nation’s leading provider of...
- 4/23/2024 12:00:00 AM
Care Supervisor
- Help at Home
-
Warren, PA
- Help at Home is hiring a Care Supervisor (Customer Service Representative)! Help at Home is the nation’s leading provide...
- 4/23/2024 12:00:00 AM
About Wisconsin
Wisconsin is bordered by the Montreal River; Lake Superior and Michigan to the north; by Lake Michigan to the east; by Illinois to the south; and by Iowa to the southwest and Minnesota to the northwest. A border dispute with Michigan was settled by two cases, both Wisconsin v. Michigan, in 1934 and 1935. The state's boundaries include the Mississippi River and St. Croix River in the west, and the Menominee River in the northeast.
With its location between the Great Lakes and the Mississippi River, Wisconsin is home to a wide variety of geographical features. The state is divided into five dist...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Managed Care Supervisor jobs
$75,233 to $103,830
Most Popular Cities in Wisconsin for Managed Care Supervisor Jobs
What does a Managed Care Supervisor do?
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