Administrative Supervisor

Bakersfield Family Medical Group•Bakersfield, CA

6h•$35 - $41

About The Position

Under the direction of the Director of Utilization Management & Customer Service, this position is responsible to support senior leadership in the oversight of UM administrative staff including the development and implementation of UM operations and processes. The UM Administrative Supervisor will interact with other departments, clinic personnel, and outside providers in a professional and friendly manner, to create and maintain a positive relationship with our internal and external customers.

Requirements

High school diploma or GED certification, required.
Two years’ experience in a healthcare facility, required
Two years’ experience of oversight of staff in a healthcare environment.
Knowledge of the HMO referral process, eligibility verification and health plan benefit interpretation.
Excellent critical thinking, organizational, and problem solving skills required.
Ability to work effectively across functional areas of the company.
Computer proficiency required.
Ability to multi-task and work with frequent interruptions.
Strong communication skills.
Ability to maintain confidentiality of patient and business records.

Responsibilities

Acts as a subject matter expert and provide guidance on UM process functions.
Monitoring of daily UM workflow, turnaround times of referral decisions as well as provider and member notification compliance.
Monitor UM administrative quality metrics and identify trends, risks, or opportunities for process improvement.
Ensure UM administrative staff adhere to current UM processes in accordance with policy and procedures.
Identify potential compliance risks within UM administrative workflows and escalate concerns appropriately.
Execute reports utilizing available reports and/or work with data analyst teams on developing reporting, as needed.
Investigate, follow up and provide responses to complaints, grievances or concerns related to UM processes and escalate issues appropriately.
Serve as a liaison between UM administrative staff and internal departments to resolve operational or system related issues.
Assist with development and implementation of UM processes to ensure alignment with HPN policy, including regulatory standards and expectations.
Communicating with staff when they will be out of the office, assigning staffing coverage and workload balancing to meet UM operational needs and turnaround time requirements with accuracy and fluency.
Responsible for staff timesheets, edits, time off requests and ensuring timely submission to Employee Services.
Champions and adapts to regulation and necessary departmental procedural changes that affect UM processes.
Leads and facilitates UM administrative meetings, including staff meetings, huddles and operational discussions.
Oversee the coordination, preparation and timely submission of audit documentation and audit file packages.
Ensures all regulatory and internal audit requirements are met, completed accurately and within required timeframes.
Supervises, guides, counsels and coaches administrative staff on organization and departmental policy, performance expectations and regulatory requirements.
Prepare and conduct fair and objective performance appraisals for administrative staff members in a timely manner of anniversary dates.
Coordinate staff schedules to efficiently handle incoming referrals and phone call volumes.
In conjunction with the Director of UM, interview and participate in the staff hiring process.
Supervising, setting goals and objectives, delegating and assigning responsibilities.
Providing mentoring, coaching and development and growth opportunities to assigned staff.
Evaluate employee performance, provide feedback to staff, and coaching and counseling or disciplining staff when performance issues arise.
Orientating new staff.
Conduct trainings related to UM functions across various UM roles, including development and maintenance of training materials.
Identify training gaps and opportunities for improved performance.
Cultural and Linguistics training annually.
Perform other duties as assigned.