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Health Services Clinical Supervisor/Manager, Santa Barbara, CA


CenCal Health

Supervisor

Santa Barbara, CA

March 4, 2019


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Description

  • Provide education and training to health services clinical and administrative staff
  • Serve as a resource for other CenCal Health staff
  • Identify areas for process improvements and assists with their implementation
  • Support administrative and clinical staff in answering phone inquiries
  • As assigned, perform retrospective claims review
  • Carry a caseload of utilization or case management activities as assigned; supports clinical staff with day-to-day activities related to the review, coordination, care planning, and transition of care
  • Interface with and serve as a resource to members and providers to clarify processes, answer questions, and address issues or concerns
  • Handle and resolve daily issues, concerns and disputes of unit staff
  • Provide new staff orientation and mentor activities
  • Assist and coordinate staff assignments and coverage
  • Identify problems or issues within established utilization management (UM) or case management (CM) processes, policies or procedures, and make suggestions for efficient resolution
  • Identify process-oriented opportunities for improvement
  • Assist with coordination and facilitation of regular staff meetings
  • Participate in internal and external audits
  • Other duties as assigned

Qualifications

Education

Required

  • Bachelors or better in Nursing or related field.

Experience

Required

  • 1-3 years: Supervisory or Management Role
  • 3 years: Practicing Registered Nurse, Social Worker, Clinical Psychologist or Psychologist

Preferred

  • 1 year: Experience with Medi-Cal and Medicare line of business
  • 1 year: Health plan or managed care experience

Licenses & Certifications

Required

  • Registered Nurse

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