Supervisor, Care Management Coordinator

Job Category:  Clinical
Department:  Care Management
Location: 

Los Angeles, CA, US, 90017

Position Type:  Full Time
Requisition ID:  4681

 

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.

Job Summary

The Supervisor of Care Management (CM) Coordinator is responsible in monitoring the coordinator’s day to day job responsibilities; ensure proper staffing and coverage. Monitors and evaluates departmental operations to ensure optimal efficiency and effectiveness.

This position provides but is not limited to: Supervision of care coordinators and clerical staff in CM department, ensuring consistent and direct feedback to staff regarding performance, customer service, and overall quality of job responsibilities. Evaluating staff performance and works with individuals to improve performance as needed. Direction to staff on resolving applicable issues within scope of work, and escalates unresolved issues to CM Manager.

The Supervisor of Care Management Coordinator is responsible in developing a successful and cohesive unit, with high level of productivity and accuracy to achieve the department's overall performance metrics.
Identifying training needs including but not limited to assisting in the development of programs, training materials, competency checklist, and orientation checklist necessary to meet educational necessities.
Facilitates the development, review and revision as appropriate of organizational and departmental policies, procedures and workflows to ensure compliance with relevant regulatory and organizational guidelines.
Responsible in training new staff and staff who needs to be crossed trained in different lines of business. Ensuring all functions are operating in accordance with regulatory compliance requirements and the organization's mission, values and strategic goals, which are focused on continuous improvement; and are provided in a manner that is responsive and sensitive to the needs of LA Care's culturally diverse membership.

In addition, the position performs Supervisory roles including payroll, employee PTO time management, supporting the designated, appropriate management team member/s, providing direction and support. The supervisor will maintain confidentiality when communicating member information, and assists with other duties as assigned.

Duties


Supervision of day to day activities of CM Coordinators, including but not limited to: - Providing direction, monitoring of staff performance and skillset for consistency and improvement for all lines of business, handling all questions/issues raised by staff.   Ensure that all departmental policies and  regulatory requirement for CM department are met; procedures and standards are being met, as well as the organization's mission, developing and ensuring proper and efficient workflow, operational activities, including staffing, productivity, and work quality. This includes but not limited to the technical aspects of the time sensitive processes for initiating cases, identifying and responding to urgency of the CM requests, appropriate documentation, case routing &tracking, routing of information, performing computer data input, faxing, accurate filing/maintenance of confidential member information, and maintaining logs of activity, etc. Ensure that deviation in performance are identified in advance and process changes are made to redirect performance to acceptable levels.   Conduct regular monthly reviews of cases and implement performance management as needed.  Recommending process improvement ensuring quantity and quality is met for overtime, ensure to provide accurate, timely and professionally written, statistical and verbal reports to management for historical, current status and forecasting purposes.

Functions as the supervisor of all non- clinical staff in CM and responsible for identification of training needs including but not limited in assisting in the development of programs, training materials, orientation checklist, and competency checklist necessary to meet educational necessities. Responsible in facilitating and coordinating the training of new staff and staff who needs to be crossed trained in different lines of business and ensure that coordinators receive identified training necessary for them to perform their task confidently, accurately, and at the highest level possible, Contributes to the hiring decisions and performance monitoring, evaluation, consultation and improvement planning of assigned staff. Consults with Manager and HR representative as needed and prior to meeting with staff to review performance improvement plans.

Monitors the internal communication and reports for urgent or unresolved member issues, Resolution of urgent or unresolved member or provider issues within 24 hrs. and/or appropriate timeframe for level of urgency of notification during normal business hours; escalation of unresolved issues to management. The technical aspects of the CM/MM activity and compliance reports are comprehensive, timely and accurate.
      
The supervisor ensures that the staff are prioritizing heir daily assignments while assessing areas of strength, weakness and building goals to achieve. Employee training and development within all core systems, new employee orientation to the departments structure and work flow assignments, support performance standards, including incentive goals and develop performance improvement plans      
Monitoring policies and procedures including but not limited to time and attendance and monthly performance audits, ensures that the employees follows the organization’s policies and procedures, providing employee resources Employee Handbook and compliance requirements.

Perform other duties as assigned. 

 

Education
Associate's Degree
Bachelor's Degree
Experience


Required:
Minimum 0-2 years of experience in managed care (Medi-Cal & Medicare and other LOB), case management, authorization processes and/or claims;) participated in a 2 years management mentoring program.

With 1-2 years of lead/supervisory experience.

Professional Licenses
Skills

Required:
Strong verbal and written communication skills.

Computer literacy with proficiency with Microsoft Word, Excel, and Access.

Excellent organizational; adaptability to computer learning. (INC)

Excellent interpersonal and time management skills.

Must be detailed oriented and an enthusiastic team player.

Ability to work independently.

Ability to solve complex issues and identify creative.

Preferred:
Knowledge of L.A. Care core computer system

Professional Certifications

Preferred:
Certification in Medical Billing 

Additional Information

 

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)


Nearest Major Market: Los Angeles

Job Segment: Medical, Clerical, Claims, Payroll, Medicare, Healthcare, Administrative, Insurance, Finance