Supervisor, Care Management Coordinator
4 weeks ago
Salary Range: $60, Min.) - $75, Mid.) - $91, Max.)
Established in 1997, L.A. Care Health Plan is an independent public agency created by the state of California to provide health coverage to low-income Los Angeles County residents. We are the nation's largest publicly operated health plan. Serving more than 2 million members in five health plans, we make sure our members get the right care at the right place at the right time.
Mission: L.A. Care's mission is to provide access to quality health care for Los Angeles County's vulnerable and low-income communities and residents and to support the safety net required to achieve that purpose.
The Supervisor of Care Management Coordinator is responsible for direct supervision and support of the team responsible for the outreach, intake, member coordination, case tracking, trending and reporting within the Care Management department. This position is accountable for leading and directing the work for the Care Coordination team by monitoring the outreach, member coordination, and communications as outlined in the state and federal regulations and company policies and procedures. The Supervisor provides support and ownership of cases identified as escalated on an as needed basis. This position collaborates with internal departments to ensure timely resolution. This position will be responsible for analyzing, trending, and ensuring assignment of all high risk and complex care management cases. Responsible for the development and maintenance of the care management procedures, workflows, member correspondence, and training as needed, or on an annual basis.
The position supervises all aspects of running an efficient team, including hiring, supervising, coaching, training, disciplining, and motivating direct-reports.
Evaluates daily reports to ensure individual and team Key Performance Indicators (KPIs), SLAs, Performance Scorecards meet regulatory requirements.
Provide direction to staff for member and provider inquiries, concerns, complaints and coordination needs. Conduct weekly 1:1s with direct reports.
Monitors and organizes staffing coverage to ensure operational effectiveness
Builds and maintains strong working relationships with internal departments and external stakeholders involved in the coordination of care for high risk and complex members.
Development, maintenance and implementation of P&Ps, workflow and training.
Staff performance oversight including case reviews and audits, and monitoring productivity
Lead and participate in team meetings
Audit preparation and providing recommendations for Corrective Action Plans from state regulatory agencies.
Responsible for the daily workflow and leading the work of assigned staff. This role will mentor, coach, act as a resource and provide feedback on performance of assigned staff.
Performs other duties as assigned.
Duties ContinuedEducation Required
Associate's DegreeIn lieu of degree, equivalent education and/or experience may be considered.Education Preferred
Bachelor's DegreeExperience
Required:
Minimum 0-2 years of experience in a healthcare or managed care setting, case management, authorization processes and/or claims with 1-2 years of lead/supervisory experience.
Preferred:
Previous experience in Managed Care preferably in Customer Service, Care Management, Appeals and Grievances and/or Claims.
Participated in a 2-year management mentoring program
Required:
Ability to manage and organize large volumes of data.
Knowledge of regulatory and accreditation entities and their requirements.
Excellent verbal and written communication skills and interpersonal skills.
Good working knowledge of licensure and regulatory requirements, and accreditation standards.
Ability to work independently.
Ability to solve complex issues and identify creative solutions.
Microsoft Office (Word, Excel, Power Point, Access, and Visio).
Preferred:
Knowledge of L.A. Care core computer system
Bilingual in one of L.A. Care Health Plan's threshold languages is highly desirable. English, Spanish, Chinese, Armenian, Arabic, Farsi, Khmer, Korean, Russian, Tagalog, Vietnamese.
Licenses/Certifications Preferred
Required Training
Preferred:
Motivation Interviewing
Trauma Informed Care
Physical RequirementsLightAdditional Information
Salary Range Disclaimer: The expected pay range is based on many factors such as geography, experience, education, and the market. The range is subject to change.
L.A. Care offers a wide range of benefits including
- Paid Time Off (PTO)
- Tuition Reimbursement
- Retirement Plans
- Medical, Dental and Vision
- Wellness Program
- Volunteer Time Off (VTO)
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