Supervisor, Clinical Support - Phoenix

Only for registered members Phoenix, United States

1 day ago

$65,000 - $73,000 (USD)

Profile · We offer remote work opportunities (AK, AR, AZ, CO, FL, HI, IA, ID, IL, KS, LA, MD, MN, MO, MT, NE, NV, NM, NC, ND, OK, OR, SC, SD, TN, TX, UT, VA/DC, WA, WI & WY only). · Our Department of Defense contract requires US citizenship and a favorably adjudicated DOD backgro ...

Job description

Profile

We offer remote work opportunities (AK, AR, AZ, CO, FL, HI, IA, ID, IL, KS, LA, MD, MN, MO, MT, NE, NV, NM, NC, ND, OK, OR, SC, SD, TN, TX, UT, VA/DC, WA, WI & WY only).

Our Department of Defense contract requires US citizenship and a favorably adjudicated DOD background investigation for this position.

Veterans, Reservists, Guardsmen and military family members are encouraged to apply

Job Summary

Responsible for supervising medical documentation functions and daily operations in support of the accurate intake, uploading, indexing, and maintenance of medical documentation in support of clinical decision-making.

This role supports clinical and non-clinical teams by ensuring medical records, referrals and authorizations and related documentation are complete, timely, and correctly associated within TriWest's medical management systems.

The Supervisor, Clinical Support functions as a subject matter resource for non-clinical documentation standards, system navigation, and data integrity, ensuring compliance with Government Contract requirements.

Ensures professional, accurate, and timely review and processing of all medical documentation and ensures that contract standards are achieved and sustained.

Supervises interdepartmental and intradepartmental communication and collaboration as needed. This role does not perform clinical review or determination activities.

Education & Experience

Required:
Associates Degree in a health care discipline, health care management or equivalent experience.
U.S. Citizen
Must be able to receive a favorable Interim and adjudicated final Department of Defense (DoD) background investigation
Two years or more of formal team lead or supervisor experience.
Two years or more health care experience
Managed care or operational experience in medical management systems, including referral management/prior authorization, health care office processes or utilization management

Preferred

Two years or more experience supervising health care operations production or medical office environment Medical records or documentation experience
Prior experience with medical record Release of Information (ROI) processing
Prior experience with remote work environments
Knowledge of TRICARE and/or Veterans' Administration Health System

Key Responsibilities

Supervises the daily operations of Clinical Operations support staff in the processing of requests for medical documentation to support clinical decision making.

Directs and supervises accurate upload, indexing, and associating of medical documentation to beneficiary records (e.g., clinical notes, discharge summaries, diagnostic reports, referrals, authorizations) in CareRadius and related systems.

Supports Clinical Operations teams by maintaining documentation standards and turnaround times in accordance with appropriate contract requirements.
Interviews, hires, onboards and trains new staff.
Provides coaching, mentoring and performance management of staff.
Serves as a non-clinical subject matter resource for document intake processes and system navigation.
Provides systems support and interpretation assistance to non-clinical staff for medical records and documentation.

Participates in the development and implementation of enhanced systems and processes to improve operational performance metrics and delivery of care.

Monitors ongoing compliance with contract standards for timeliness and quality.
Collaborates with staff for data compilation and statistical analysis.
Participates in cross-functional teams to enhance business strategies, process improvement, and use of industry best practices.
Performs other duties as assigned; regular and reliable attendance is required.

Competencies

Communication / People Skills:
Ability to influence or persuade others under positive or negative circumstances; Adapt to different styles; Listen critically; Collaborate.

Computer Literacy:

Ability to function in a multi-system Microsoft environment using Word, Outlook, TriWest Intranet, the Internet, and department software applications.

Coping / Flexibility:

Resiliency in adapting to a variety of situations and individuals while maintaining a sense of purpose and mature problem-solving approach is required.

Independent Thinking / Self-Initiative:

Critical thinkers with ability to focus on things which matter most to achieving outcomes; Commitment to task to produce outcomes without direction and to find necessary resources.

Information Management:
Ability to manage large amounts of complex information easily, communicate clearly, and draw sound conclusions.

High Intensity Environment:

Ability to function in a fast-paced environment with multiple activities occurring simultaneously while maintaining focus and control of workflow.

Leadership:
Successfully manage different styles of employees; Provide clear direction and effective coaching.

Multi-Tasking / Time Management:
Prioritize and manage actions to meet changing deadlines and requirements within a high volume, high stress environment.

Problem Solving / Analysis:

Ability to solve problems through systematic analysis of processes with sound judgment; Has a realistic understanding of relevant issues.

Technical Skills:

Thorough knowledge of health care delivery, managed care concepts, management reporting tools, and medical management systems; ability to perform critical, in-depth analysis of medical records for appropriateness and effectiveness.

Thorough knowledge of relevant Government policies and procedures, data collection and reporting (TRICARE or VA Community Care as appropriate), TriWest Care Radius medical management systems, and non-clinical support specialist functions.

Working Conditions

Working Conditions

Works non-regular hours, as required
Works within a standard office environment, with 20% travel

Remote:
Private and secure workspace and workstation with high-speed internet is required
Extensive computer work with prolonged sitting

TriWest job postings typically include a salary range, which can vary based on the specific role and location, but generally this position ranges from around $65,000 to $73,000 per year.

Company Overview

Taking Care of Our Nation's Heroes.

It's Who We Are. It's What We Do.

Do you have a passion for serving those who served?

Join the TriWest Healthcare Alliance Team We're On a Mission to Serve

Our job is to make sure that America's heroes get connected to health care in the community.

At TriWest Healthcare Alliance, we've proudly been on that important mission since 1996.

Benefits

We're more than just a health care company.

We're passionate about serving others We believe in rewarding loyal, hard-working people who are willing to learn as they grow.

TriWest Healthcare Alliance values teamwork.

Join our team, fulfill your responsibilities, and you may also be considered for frequent pay raises, overtime opportunities to earn even more, recognition and reward programs, and much more.

Of course, we also offer a comprehensive and progressive compensation and benefits package that includes:

Medical, Dental and Vision Coverage
Paid time off
401(k) Retirement Savings Plan (with matching)
Short-term and long-term disability, basic life, and accidental death and dismemberment insurance
Tuition reimbursement
Paid volunteer time

Equal Employment Opportunity

TriWest Healthcare Alliance is an equal employment opportunity employer.

We are proud to have an inclusive work environment and know that a diverse team is a strength that will drive our success.

To that end, TriWest strives to create an inclusive environment that supports diversity at every organizational level, and we highly encourage candidates from all backgrounds to apply.

Applicants are considered for positions based on merit and without discrimination on the basis of race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability or any other consideration made unlawful by applicable federal, state, or local laws.

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