Supervisor - Care Management

Astrana Health, Inc.•Monterey Park, CA

6h•$85,000 - $980,000•Hybrid

About The Position

The Supervisor – Care Management (Model of Care) position is responsible for the direct daily supervision of care management activities of case managers and care coordinators for assigned Model of Care populations. This role ensures high-quality, cost-effective, and patient-centered care through effective supervision of care management operations, clinical staff, and interdisciplinary care coordination. The Supervisor will serve as a key leader in maintaining compliance with health plan requirements, regulatory guidelines, and internal quality standards. This role reports to the Manager, Care Management.

Requirements

Active RN or LVN unrestricted license required
Minimum of 3+ years of care management experience in a medical group, IPA, or HMO setting
Associate Degree of Science in Nursing
Skilled with the use of the Microsoft Office suite of products and the ability to use and effectively learn and navigate other computer systems

Nice To Haves

Bachelor’s degree in healthcare related fields
Knowledge of NCQA standards, Model of Care and Case Management requirements, CMS and state regulations, and HMO/ACO model structures
Strong communication, leadership, and critical thinking skills
Proven ability to work cross-functionally with clinicians, leadership, and administrative staff to drive outcomes
Experience in managing diverse teams and leading quality-focused initiatives

Responsibilities

Provide daily supervision of care management teams, ensuring adherence to ambulatory care management, model of care policies, procedures and regulatory requirements.
Oversee clinical care management services across the continuum, supporting staff performance and clinical quality.
Ensure consistent application of policies and implement corrective or disciplinary actions when needed.
Monitor and support implementation of the Astrana Health care management process, including training and documentation.
Review health plan reports to identify members needing care coordination or targeted interventions.
Ensure all care management activities comply with NCQA standards, CMS, health plan and state regulations, and internal protocols.
Support development and review of individualised care plans and integrate care strategies across disciplines.
Lead or participate in Multi-Disciplinary Care Team (MDT) meetings, providing operational insight and solutions for complex cases.
Engage with network PCPs, specialists and vendors to ensure timely, appropriate care coordination and service use.
Collaborate with Utilisation Management, Inpatient Case Management and Ambulatory Care to ensure continuity across care transitions.
Monitor and evaluate case management plans, modifying as needed to meet regulatory requirements, coordinate services, evaluate treatments, intervene in crises and provide support.
Conduct internal audits of ambulatory care management cases and provide feedback and coaching to staff.
Educate and support staff on documentation standards, best practices and quality improvement opportunities.
Assist with submission deliverables for health plan audits.
Conduct performance evaluations of care management staff, including audits of care plans, assessments and documentation.
Monitor staff attendance and ensure accountability to organisational expectations.
Provide mentorship and training to foster excellence, collaboration and continuous improvement.
Oversee hiring, onboarding and training of new staff.
Maintain staff timekeeping and personnel records.