Supervisor, Operations - Woodland Hills, United States - Blue Shield of California

Blue Shield of California

Verified Company

Woodland Hills, United States

3 weeks ago

Posted by:

Mark Lane

beBee recruiter

Description

**Your Role
The Medicare Appeals and Grievances team is responsible for compliance processing of Medicare appeals and grievances. The Operations, Supervisor will report to the Sr. Manager for Medicare Appeals and Grievances.

In this role you will manage the daily, short-term, and/or long-term activities of the customer service and operations teams to ensure alignment with service levels and providing service worthy of our family and friends.

You will be responsible for the oversight of quality, production levels, strategic initiatives, employee development, preparation and management of budgets, goals, objectives, and results for various operational areas.

Our leadership model is about developing great leaders at all levels and creating opportunities for our people to grow - personally, professionally, and financially.

**Your Work

In this role, you will:

Be responsible for routine operations and people management functions
Foster a great place to work communicating clear roles and responsibilities and building successful working relationships across the organization
Consult and make recommendations to management on operational issues
Use concepts and abilities to manage processes and operations, including procedural changes, inventories, and workload management
Stay up to date on legislation and regulations to ensure team compliance
Interpret audit information requests, prepare narratives, conduct preliminary risk assessments, anticipate adverse findings to prepare for internal corrective action plans
Make decisions on people and operational matters consistent with goals and objectives
Provide coaching, performance management, skill development, and guidance on team members' Professional Development Plans
Contribute towards achieving the organizations Medicare Stars goals

**QUALIFICATIONS
Your Knowledge and Experience

Requires a high school diploma or GED
Requires a minimum of 5 years of prior relevant experience
Requires a minimum of 2 years of experience operating in a lead role or equivalent leadership training or manager training
Knowledge of Medicare and Medi-Cal regulations preferred
Experience working with appeals and grievances in healthcare preferred Ability to work collaboratively across diverse teams to improve processes and policies with a focus on the customer experience.

Pay Range:

The pay range for this role is: $ 66,600 to $ 98,900 for California.

Note:

ABOUT THE TEAM

Blue Shield of California's mission is to ensure all Californians have access to high-quality health care at a sustainably affordable price.

We are transforming health care in a way that genuinely serves our nonprofit mission by lowering costs, improving quality, and enhancing the member and physician experience.

To fulfill our mission, we must ensure a diverse, equitable, and inclusive environment where all employees can be their authentic selves and fully contribute to meet the needs of the multifaceted communities we serve.

Our continued commitment to diversity, equity, and inclusion upholds our values and advances our goal of creating a healthcare system that is worthy of our family and friends while addressing health disparities, promoting social justice, and integrating health equity through our products, business practices, and presence as a corporate citizen.

Blue Shield has received awards and recognition for being a certified Fortune 100 Best Companies to Work, Military Friendly Employer, People Companies that Care, a Leading Disability Employer, and one of California's top companies in volunteering and giving.

Here at Blue Shield, we strive to make a positive change across our industry and communities - join us

Our Values:

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Honest . We hold ourselves to the highest ethical and integrity standards. We build trust by doing what we say we're going to do and by acknowledging and correcting where we fall short.
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Human . We strive to be our authentic selves, listening and communicating effectively, and showing empathy towards others by walking in their shoes.
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Courageous . We stand up for what we believe in and are committed to the hard work necessary to achieve our ambitious goals.

Our Workplace Model:

Blue Shield of California is dedicated to making work-life balance a reality. Whether you prefer to work in an office or from home, we understand flexibility is more important than ever.

That's why Blue Shield is a hybrid company, offering you the opportunity to decide where you can do your best and most meaningful work.

Two ways of working:
Hybrid (our default) and office

Hybrid
In a business unit approved office a few times per year to 3 days per week, on average

Physical Requirements:

Office Environment - roles involving part to full time schedule in Office Environment. Due to the current public health emergency in California, Blue Shield employees are almost all working remotely. Based in our physical offices and work from home offic