CalOptima logo
CalOptima

CalOptima Health is a county-organized health system administering health insurance programs for residents of Orange, California. The organization strives to se

Supervisor Case Management

Location

California

Posted

18 hours ago

Salary

$109.9K - $175.8K / year

Seniority

Senior

Bachelor Degree

Job Description

Supervisor Case Management

CalOptima

Supervisor Case Management Location: Orange United States Job Description: Supervisor Case Management - 505 City Parkway West, California, United States - Medical / Clinical - Full Time Add to favorites View favorites Join Us in this Amazing Opportunity The Team You'll Join We are a mission driven community-based organization that serves member health with excellence and dignity, respecting the value and needs of each person. If you are ready to advance your career while making a difference, we encourage you to review and apply today and help us build healthier communities for all. More About the Opportunity We are hoping you will join us as a Supervisor Case Management and help shape the future of healthcare where you'll be an integral part of our Case Management team, helping to strive for excellence while we serve our member health with dignity, respecting the value and needs of each of our members through collaboration with our providers, community partners and local stakeholders. This position has been approved to be Full Telework. - If telework is approved, you are required to work within the State of California only and if Partial Telework, also come in to the Main Office in Orange, CA, at least two (2) days per week minimum. The Supervisor Case Management will be responsible for the daily operation of case management activities, the implementation of new programs and compliance with regulations. You will provide guidance to staff or will directly handle complex case management referrals. You will be accountable for establishing quality and productivity standards for the team and ensuring compliance with department policies and procedures in collaboration with the manager. You will serve as a resource for CalOptima Health's providers, health networks and community partners. Together, we are building a stronger, more equitable health system. Your Contributions To the Team: - 50% - Program Support - Participates in a mission-driven culture of high-quality performance, with a member focus on customer service, consistency, dignity and accountability. - Assists the team in carrying out department responsibilities and collaborates with others to support short- and long-term goals/priorities for the department. - Oversees the process, management and tracking of case management referrals. - Assists with the development and oversight of case management programs, work plans and reports. - Assists in developing and revising policies and procedures to ensure National Committee for Quality Assurance (NCQA), Centers for Medicare and Medicaid (CMS) and Department of Health Care Services (DHCS) regulatory compliance. - Creates, documents and updates desktop procedures. - Participates in health network oversight activities. - Assists with assessment activities and other process improvement strategies to enhance the effectiveness of the case management department. - Maintains knowledge of current regulatory requirements and industry trends. - Participates in internal and external committees, coalitions and events such as health fairs, as appropriate. - 45% - Supervisory - Mentors, trains and manages a team of case managers and non-licensed staff. - Collaborates with other supervisors and managers in the department to improve processes and workflow. - Attends meetings on behalf of the manager as needed. - 5% - Other - Completes other projects and duties as assigned. Do You Have What the Role Requires? - Bachelor's degree in a health care related field or a current unrestricted Registered Nurse (RN) license to practice in the state of California required. - 3 years of experience in ambulatory case management required. - 1 year of managed care experience, preferably with Medicare and Medicaid/Medi-Cal populations, required. You'll Stand Out More If You Possess the Following: - For RN's, a bachelor's degree in nursing, public health or another health care related field. - For non-RN's, a master's degree in healthcare, social work or related field. - Active Certified Case Manager (CCM) certification. - Previous lead or supervisory experience. What the Regulatory Agencies Need You to Possess? - N/A Your Knowledge & Abilities to Bring to this Role: - Develop rapport and establish and maintain effective working relationships with CalOptima Health''s leadership and staff and external contacts at all levels and with diverse backgrounds. - Work independently and exercise sound judgment. - Communicate clearly and concisely, both orally and in writing. - Work a flexible schedule; available to participate in evening and weekend events. - Organize, be analytical, problem-solve and possess project management skills. - Work in a fast-paced environment and in an efficient manner. - Manage multiple projects and identify opportunities for internal and external collaboration. - Motivate and lead multi-program teams and external committees/coalitions. - Utilize computer and appropriate software (e.g., Microsoft Office: Word, Outlook, Excel, PowerPoint) and job specific applications/systems to produce correspondence, charts, spreadsheets, and/or other information applicable to the position assignment. Your Physical Requirements (With or Without Accommodations): - Ability to visually read information from computer screens, forms and other printed materials and information. - Ability to speak (enunciate) clearly in conversation and general communication. - Hearing ability for verbal communication/conversation/responses via telephone, telephone systems, and face-to-face interactions. - Manual dexterity for typing, writing, standing and reaching, flexibility, body movement for bending, crouching, walking, kneeling and prolonged sitting. - Lifting and moving objects, patients and/or equipment 10 to 25 pounds Ways We Are Here For You - You'll enjoy competitive compensation for this role. - Our current hiring range is: Pay Grade: 315 - $109,892 - $175,827 ($52.83 - $84.5322). - The final salary offered will be based on education, job-related knowledge and experience, skills relevant to the role and internal equity among other factors. - This position is approved for Full Telework (If the position is Telework, it is eligible in California only) - A comprehensive benefits package - CalPERS pension program and additional retirement packages. - Additional benefits and perks including: - A generous PTO program - A quality work life balance - Various wellness programs - Tuition Reimbursement - Professional development opportunities - Career development opportunities - Flexible scheduling - And the satisfaction of knowing your work directly impacts and improves healthcare access for thousands of individuals and families. Our Work Environment: If located at the 500, 505 Building or a remote work location: - Work is typically indoors and sedentary and is subject to schedule changes and/or variable work hours, with travel as needed. - There are no harmful environmental conditions present for this job. - The noise level in this work environment is usually moderate. If located at PACE: - Work is typically indoors in a clinical setting serving the frail and elderly. - There may be harmful or hazardous environmental conditions present for this job. - The noise level in this work environment is usually moderate to loud. If located in the Community: - Work is typically indoors and sedentary and is subject to schedule changes and/or variable work hours, with travel as needed. - Employee will occasionally work outdoors in varied temperatures. - There may be harmful or hazardous environmental conditions present for this job. - The noise level in this work environment is usually moderate to loud. Why Join Us? We believe that diverse perspectives drive innovation. Each employee brings a unique perspective to the overall team and we value everyone''s input and we are committed to creating an inclusive environment where you and every team member can thrive while making a meaningful impacts on our community members. Our team reflects and represents the communities we serve, and we welcome candidates from all backgrounds who share our commitment to accessible, quality healthcare.

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