Supervisor,Reg CM Referrals

DaVita Medical Group - Arcadia, CA

Full-time
***This position will be based in Arcadia, CA***

OVERVIEW:
Responsible for overseeing the referral processing functions of the site-based Referral Coordinators to ensure that patients receive accurate and timely authorizations before leaving the PCP site when appropriate, and to oversee that referrals needing clinical review are sent to the regional Care Management department. Works collaboratively with department management staff as well as site administration to ensure that cross-functional issues are addressed in a timely and efficient manner. Conducts on-site visits to evaluate site-based Care Coordinators performance level.

ESSENTIAL FUNCTIONS:
Consistently exhibits behavior and communication skills that demonstrate HealthCare Partners’ (HCP) commitment to superior customer services with each and every internal and external customer.
Supervises site-based Care Coordinators including selection, training, and performance evaluation, and manages schedules to maintain adequate operations.
Routinely communicates with Site Administrators to appropriately monitor daily performance of site-based Care Coordinators.
Works in conjunction with other CM Referrals Supervisors to ensure consistency of the referral process across regions and to develop additional processes to ensure success.
Ensures that appropriate HCP Policies and Procedures concerning referrals are rolled out and followed.
Attends meetings as necessary to provide input and obtain information and communicates results appropriately.
Functions as a key resource to all site-based Care Coordinators.
Participates in continuous quality improvement of the referral process by analyzing processes and identifying areas where improvements are needed. Initiates necessary steps to make changes when appropriate.
Ensures that appropriate monitoring tools are developed, used and communicated to appropriate parties for the referrals area of the IMCS core business system.
Monitors productivity levels of site-based Care Coordinators on a quarterly basis.
Maintains professional relationships as appropriate with specific health plans, area hospitals and providers.
Works cooperatively with other departments.
Participates in meetings as delegated.
Communicates all issues and concerns as appropriate to their regional VP/Director of Care Management.
Uses, protects, and discloses HCP patients’ protected health information (PHI) only in accordance with Health Insurance Portability and Accountability Act (HIPAA) standards.
Performs additional duties as assigned.
***This position will be based in Arcadia, CA***

EDUCATION:
Bachelor’s degree from a four-year college and/or a professional certification requiring formal education beyond a two-year college highly preferred.

EXPERIENCE:
Minimum:
Over 3 years and up to and including 5 years of experience.
Supervisory experience.

Preferred:
3 years experience in healthcare industry in a referrals or equivalent function.

KNOWLEDGE, SKILLS, ABILITIES:
Computer literate.
General knowledge of medical terminology and ICD-9 and CPT coding.
Valid California driver’s license.
Strong verbal and written communication skills.
Time management skills.
***This position will be based in Arcadia, CA***

What's the first thing that happens when one of the leading independent medical groups in the country comes together with a global leader in health care? Opportunity. With DaVita Medical Group, HealthCare Partners, The Everett Clinic, Northwest Physicians Network, MountainView Medical Group and Magan Medical Clinic joining OptumCare and the UnitedHealth Group family of companies, people like you will find increasing levels of challenge, impact and professional success. We're changing health care for the better by improving access to affordable, high quality care, and working together to improve the patient experience. That takes passion, commitment, intense focus and the ability to contribute effectively in a highly collaborative team environment. Are you with us? Learn more about this exciting opportunity to do your life's best work.(SM)

Careers with OptumCare. Here's the idea. We built an entire organization around one giant objective; make the health system work better for everyone. So when it comes to how we use the world's large accumulation of health - related information, or guide health and lifestyle choices or manage pharmacy benefits for millions, our first goal is to leap beyond the status quo and uncover new ways to serve. OptumCare, part of the UnitedHealth Group family of businesses, brings together some of the greatest minds and most advanced ideas on where health care has to go in order to reach its fullest potential. For you, that means working on high performance teams against sophisticated challenges that matter. Here you’ll find incredible ideas in one incredible company and a singular opportunity to do your life's best work.(SM)

Diversity creates a healthier atmosphere: OptumCare and its affiliated medical practices are Equal Employment Opportunity/Affirmative Action employers and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law. OptumCare and its affiliated medical practices is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.