Supervisor, Managed Long Term Services and Supports (Clinical)

L.A. Care Health Plan•Los Angeles, CA

9d•$102,183 - $163,492

About The Position

Established in 1997, L.A. Care Health Plan is an independent public agency created by the state of California to provide health coverage to low-income Los Angeles County residents. We are the nation’s largest publicly operated health plan. Serving more than 2 million members, we make sure our members get the right care at the right place at the right time. Mission: L.A. Care’s mission is to provide access to quality health care for Los Angeles County's vulnerable and low-income communities and residents and to support the safety net required to achieve that purpose. Job Summary The Supervisor, Managed Long Term Services and Supports (MLTSS) supervises all aspects of running an efficient team, including hiring, supervising, coaching, training, disciplining, and motivating direct reports. This position provides a high-performing, collaborative work environment aligned with departmental goals. The Clinical Supervisor assists in triaging and resolving operational issues within the scope of work and escalates matters to the senior management when appropriate. The Supervisor supports to the department’s program development and continuous process improvement efforts, participates in cross-functional workgroups and committees, and contributes to the creation and maintenance of policies, procedures, job aids, and training materials to support staff education and competency This position is also responsible for ensuring all functions are operating in accordance with the organization's mission, values and strategic goals, which are focused on continuous improvement; and are provided in a manner that is responsive and sensitive to the needs of L.A. Care's culturally diverse membership.

Requirements

At least 5 years of clinical nursing experience in direct patient care, such as ambulatory care, home care, palliative care, hospice care OR experience in Utilization Review or Care Management will be considered in lieu of direct patient care.
At least 2 years in leading a process, program and/or staff or supervisory experience.
Experience with state Medi-Cal regulations and requirements.
In-depth knowledge of MLTSS administered services such as Community Based Adult Services (CBAS), Skilled Nursing Facility (SNF) services, Intermediate Care Facility for Developmentally Disabled (ICF/DD) services, CalAIM Community Supports, Palliative and Hospice Care.
Knowledge of state, federal and regulatory requirements in Utilization Management and Care Management.
Strong clinical and leadership skills with a knowledge of care needs for elderly, disabled, and/or frail populations and has applied knowledge of End-of-Life care.
Excellent verbal and written communication skills
Excellent problem solving, planning and organizational skills. Strong time-management and priority-setting skills.
Must be detailed-oriented, energetic, and an enthusiastic team player.
Provision of excellent customer service required due to frequent communication with providers, members and interdisciplinary team.
Must be computer literate and proficient in Microsoft Office (Outlook, Word, Excel, PowerPoint, Teams).
Effectively utilize computer and appropriate software and interacts as needed with L.A. Care Information System.
Must be able to work independently.
Maintains strict member confidentiality and complies with all HIPAA requirements.
Registered Nurse (RN) - Active, current and unrestricted California License

Nice To Haves

Completion of the L.A. Care Management Certificate Training Program may substitute for the supervisory/management experience requirement
Bilingual in one of L.A. Care Health Plan’s threshold languages is highly desirable. English, Spanish, Chinese, Armenian, Arabic, Farsi, Khmer, Korean, Russian, Tagalog, Vietnamese.
Case Management Certificate

Responsibilities

Directly responsible for the development, organization, direction and oversight of assigned clinical staff. Supervision of staff includes, but not limited to monitoring of day-to-day activities of staff, creates schedules, manages PTO requests, provides guidance and feedback to staff on performance, mentoring, training, and cross-training of staff, addressing questions or issues raised by staff, encourage staff to provide recommendations for relevant process and systems enhancements, among others.
Responsible for the daily workflow and supervising the work of assigned staff, the overall efficiency and productivity of assigned team. This role will mentor, coach, act as a resource and provide feedback on performance of assigned staff.
Monitors staff performance including but not limited to productivity, quality and compliance with regulatory and organizational requirements.
Serves as the primary resource for internal stakeholders regarding program-related inquiries and technical issues; escalates to MLTSS Clinical Management when necessary. Acts as a consultant to other business units and organizations as needed.
Evaluates operations and recommends process improvements to streamline workflows, enhance efficiency and productivity to achieve departmental goals and performance metrics.
Demonstrates subject matter expertise in MLTSS program requirements and maintains working knowledge of federal and state regulations, including but not limited to Department of Health Care Services (DHCS) All Plan Letters (APL), Title 22, CalAIM, and provider contractual obligations. Educates and provides resources for management team on key initiatives to facilitate communication between key internal and external stakeholders.
Leads collaboration with Medical Directors, social workers, and interdisciplinary care team (ICT); actively participates in ICT meetings and provides recommendations related to MLTSS administered programs.
Serves as a lead liaison for MLTSS, developing and maintaining positive working relationships with internal and external stakeholders to support optimal member care and provider satisfaction.
Oversees and monitors provider performance to ensure adherence with regulatory standards and contractual agreements. Participates in provider audits and quality improvement initiatives.
Collaborates with Provider Network Management (PNM) and participates in Joint Operations Meetings (JOM).
Performs other CM and UM functions as assigned and as needed /required by L.A. Care, to maintain regulatory requirements and company objectives.
Perform other duties as assigned.