Program Supervisor-Community Supports-Hybrid

Partners in Care Foundation In•San Fernando, CA

2d•$70,304 - $80,000•Hybrid

About The Position

The Community Supports Supervisor for Private Duty will oversee a team of Community Support Coordinators (CSCs) who provide referral management, including assignments to our Network Members, to ensure access to Personal Care Homemaker Services and/or Non-Medical Respite (“Private Duty” or “PD”) as authorized by our payors.

Requirements

B.A. in human development, social work, psychology, counseling, rehabilitation, gerontology, sociology or related field.
Minimum of 3 years of experience required working in healthcare or multidisciplinary community-based settings providing case management or care coordination services. (Adult/people with disabilities-focused social work preferred.)
Minimum of four years of experience required working with diverse individuals and families experiencing health related social needs.
Minimum of 2-3 years of supervisory experience required.
Highly motivated with minimal supervision and strong attention to detail.
Excellent organizational skills and the ability to multitask and work under pressure.
Proven track record of identifying opportunities for improvement and implementing solutions proactively.
Adaptable, dependable and a team player.
Strong verbal and written communication skills
Strong data entry and computer skills experience.
Proficiency in Excel, ability to filter data, create spreadsheets, and analyze data to support billing and operational functions.
Knowledge of community-based programs.
Ability to work with multidisciplinary team, clients and their families.
Passionate about improving the lives of diverse individuals and families experiencing health related social needs.

Nice To Haves

Bilingual preferred.

Responsibilities

Manage and safeguard protected health information.
Guide and supervise team of CSCs for accuracy, timeliness and follow through of program referrals and processing ensuring it meets Managed Care Plan (MCP) and program standards.
Support and ensure team meets the entirety of the referral workflow cycle including but not limited to intake, review, and processing of referrals from internal departments and external stakeholders and maintaining open communication to members, Home Care Organizations (HCOs), MCPs staff and internal team members (i.e, using various MCP portals, encrypted emails, efax, referral forms, and other platforms such as sFTP.)
Support to ensure accuracy of created person accounts, zip codes, and rates for network agencies in Partners in Care Foundation’s (Partners’) database.
Support with generating and reviewing program reports and/or program dashboards and follow up on required items for program leadership team and/or MCPs as needed.
Support daily communication with our Network Members - Home Care Organizations (HCOs), to assign referrals, obtain referral disposition feedback and updates, provide authorization start/end date follow up, authorization extension and modification follow-up and processing, and support HCOs to ensure quality service delivery is maintained to meet contractual requirements and compliance.
Create and lead internal and external in-services about PD services and liaison with internal teams and departments to provide linkages to services or support for PD referrals or HCOs as appropriate.
Assist with the development or amendments of program process’ to streamline and support workflows (i.e. developing process for eligibility checks, obtaining discharge paperwork, satisfaction survey data, as needed etc.).
Conduct weekly data quality checks and ensure follow-up, authorization cycles, outbound calls, outreach and necessary supporting documentation is maintained in Partners’ database and/or payor platforms.
Attend weekly team meetings, trainings and other program related meetings that support Partners’ services and programs.
Work collaboratively with PD team to onboard and provide orientation training for new PD network members and ensure all necessary documents for PD program are shared with new network members, revised and amended as needed.
Address elevated program related calls, emails and inquiries from various entities including HCA’s, MCP members, Payors, Partners’ staff, community members and elevate disputes or concerns to supervisor.
Ensure appropriate reporting of Quality Incident Reports, APS, and grievances, taking necessary steps to address and remedy grievances with all involved parties. Provide ongoing support and guidance for CSCs with these items as needed.
Schedule weekly check ins with team to support and guide CSCs, ensure performance and goals are on track; review and approve time sheets; and provide annual performance review feedback.