Supervisor, Care Management NonClinical Health Integrated
THIS JOB HAS EXPIRED
Description
JOB SUMMARY: The Operations Coordinator Supervisor is a non-clinical full-time position responsible for the daily management of Operation Coordinator?s for the Regence Enhanced Concurrent Review environment. Team Leads report to this supervisor position. The supervisor supervises staff in multiple locations including remote or telecommuter staff, including hiring, coaching, training and completion of performance evaluations. Assists with policy and procedures, ensures daily operations of phones, census review, case building, fax box management is maintained. This position may not conduct any activities that require evaluation or interpretation of clinical information.
Minimum Qualifications:
Education/License/Certification: High School Diploma required. AA/BA desired unless demonstrated equivalent years of experience provided.
Experience: Minimum 3 years of experience in the healthcare industry with at least two (2) years management experience.
Knowledge/Skills: Proficient with MS Word, MS Excel, & MS Outlook;
Working knowledge of hospital census, Clinical Care Advance UM systems of assigned clients, eligibility, fax and Radar systems. Demonstrate excellent organization and data entry skills; Effective communication skills;
and able to articulate complex information to both clinical and non-clinical audiences
Accountabilities:
Job Performance/Responsibilities:
Percent
Active Staff Management
80%
Promotes working relationships that support the growth and success of staff members;
Identifies potential intradepartmental personnel problems and issues proactively and readily utilizes HI Human Resources policies and procedures to facilitate resolutions;
Communicates to Manager of Care Management all problems, concerns and/or makes recommendations when opportunities for improvement in staffing management are identified;
Conducts monthly staff performance reviews in a consistent, accurate and timely manner consistent with HI policies and procedures;
Maintains a team approach in writing, delivering and evaluating performance and implementing corrective actions by utilizing the expertise of the Manger of Care Management;
Identifies potential for reorganizing or redirecting staff activities to promote efficient delivery of services;
Identifies and promotes educational/training opportunities for the staff, serving as a resource professional.
Performs Quality Audits on all Client Service Representatives on a monthly basis, providing findings and feedback during delivery the of monthly evaluation process.
Has a clear and precise understanding of non-clinical responsibilities/functions and directs all clinical issues to clinicians as needed utilizing the Manager of Care Management
20%
General Staff Management
Participates in the maintenance of staffing levels; recommends hiring and termination staffing decisions to Manager. In Manager?s absence, can execute either with Sr. Director guidance from Operations or HR.
Maintains and promotes expertise administrating the client product, including client specifics, by ensuring staff conduct the non-clinical activities in accordance with client demands and HI contractual obligations
Identifies, investigates, evaluates, resolves and conducts follow-up on all policies and procedures issues including the intranet Adverse Quality occurrence policy/concerns, and communicates any issues/concerns with the Manager of Care Management;
Has a clear understanding of all HI policies and procedures, delivers pertinent information to the non-clinical staff ;
Provides the day-to-day professional and technical support to the non-clinical staff to ensure efficient operation of the department. Remains compliant with policies and procedures, contractual obligations and regulatory and accreditation requirements at all times;
Customer Services-Internal
Promotes a positive working environment by working with manager and staff to develop a high level of morale, positivity, and commitment in the work environment;
Provide strong leadership role model for staff
Identify problems, issues and/or concerns proactively or as they arise and resolves them as quickly as possible
Maintains a courteous and professional attitude when working with all HI staff members and the management team; and,
Actively participates in team meetings.
Identifies, communicates, and resolves potential interdepartmental personnel/peer problems and issues proactively, readily utilizing the Operations manager, and when appropriate managerial staff, as resources;
Customer Service-External
Works, communicates and collaborates in a courteous, professional manner with patients, client/health plans, and all members of the Regence Enhanced Concurrent Review team on all initiatives;
Effectively resolves issues and communicates appropriately and according to HI policies and procedures, and/or regulatory requirements with the practitioner(s), provider(s), patient/patient?s legally appointed representative;
| Location: |
10008 North Dale Mabry
Tampa, FL 33618
United States
|
THIS JOB HAS EXPIRED