Community Based LTC Support Supervisor

The challenges of affordable healthcare continue to create new opportunities. Elderplan and HomeFirst, our Medicare and Medicaid managed care health plans, are outstanding examples of how we are expanding services in response to our patients' and members' needs. These high-quality healthcare plans are designed to help keep people independent and living life on their own terms.

Provides daily oversight of the Placement and Utilization Support Department. Responsibilities include but not limited to staffing, call monitoring, quality assurance/process monitoring, customer problem resolution, enrollment, and provider relations. Assist Manager of Clinical Support in creation and implementation of all projects, policies, and workflows to ensure full compliance. Responsible for outcomes of all service authorizations and documentation processing and assisting in problem solving as new duties arise and volumes fluctuate. Ongoing monitoring of staff punctuality, attendance, and quality of work.

• Baccalaureate Degree preferred, 3 to 4 years' experience in healthcare.

• 4-5 years experience in business, human services, or a health-related field. 2-3 years experience in provider relations and/or member services in managed care. Prior experience with Medicaid managed care. Knowledge of the service delivery needs of the elderly, chronically ill or disabled.

  Demonstrates knowledge/ability of: Institutional goals and changing trends in health care and Cost factors in delivering patient care.
• Proficiency in MS Word and Excel. Knowledge of Telephony systems and Windows operating systems. Must be knowledgeable of new trends in clinical management and information systems and be able to apply data processing technology for the clinical and physician services areas.