Supervisor Health Plan Operations - USFHP

Providence • Renton, WA

6d

About The Position

The Supervisor Health Plan Operations – USFHP organizes and directs daily activities and department workflow for the Referrals and Referral Support Staff under the supervision of the Director of USFHP Operations. The role ensures accurate and timely data entry and processing of authorizations and referrals related to Pacific Medical Centers’ revenues and expenses for Outside e (OPS), and assures compliance with Department of Defense and other government agency guidelines and contract requirements.

The supervisor sets referral policy and monitors compliance, tracks Medicare and TRICARE referral guidelines, and educates staff about changes. The position also identifies and resolves processing issues with outside providers, serves on the US Family Health Plan management team, and jointly manages the US Family Health Plan budget with the Director of USFHP Operations and other management team members.

Requirements

• Four years of health care referrals experience.
• Two years of experience in a supervisory capacity, including a Lead role, or six months of supervisory experience within a health plan.

Nice To Haves

• Bachelor's degree in Health Care Administration or Business Administration.

Responsibilities

• Organize and direct daily activities and department workflow for Referrals and Referral Support Staff.
• Ensure accurate and timely data entry and processing of authorizations and referrals related to Pacific Medical Centers’ revenues and expenses for Outside e (OPS).
• Ensure compliance with DoD and other government agency guidelines and contract requirements.
• Set referral policy and monitor compliance.
• Monitor Medicare and TRICARE referral guidelines and educate staff about changes.
• Identify and resolve processing issues with outside providers.
• Serve as a member of the US Family Health Plan management team.
• Jointly manage the US Family Health Plan budget with the Director of USFHP Operations and other management team members.

Benefits

• The company describes its benefits as designed to support employees and their families in staying well, growing professionally, and achieving financial security. Specific benefit offerings are not listed.

What This Job Offers

• Job Type: Full-time
• Career Level: Manager
• Education Level: No Education Listed