Managed Care Supervisor jobs in Orange, CA

Managed Care Supervisor supervises and coordinates activities of personnel in the managed care operations department of a healthcare facility. Oversees staff that process referrals, authorizations, billing, utilization review, and capitation for hospital services. Being a Managed Care Supervisor experienced in utilization review techniques and protocols. Requires a bachelor's degree. Additionally, Managed Care Supervisor typically reports to a manager or head of a unit/department. May require Registered Nurse (RN). Makes day-to-day decisions within or for a group/small department. Has some authority for personnel actions. The Managed Care Supervisor supervises a group of primarily para-professional level staffs. May also be a level above a supervisor within high volume administrative/ production environments. To be a Managed Care Supervisor typically requires 3-5 years experience in the related area as an individual contributor. Thorough knowledge of functional area and department processes. (Copyright 2024 Salary.com)

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PBM / Managed Care Pharmacist
  • Pharmacy Careers
  • Irvine, CA FULL_TIME
  • We are currently seeking a skilled and motivated Pharmacist with expertise in Pharmacy Benefit Management (PBM) and Managed Care. In this pivotal role, you will be responsible for overseeing medication utilization, formulary management, and ensuring cost-effective pharmacy services. The ideal candidate will bring a deep understanding of managed care principles, a proactive approach to problem-solving, and a commitment to optimizing pharmacy outcomes within a managed care environment.

    Preferred Qualifications:
    PharmD degree from an accredited pharmacy program
    Previous experience in Pharmacy Benefit Management (PBM) or Managed Care
    Knowledge of formulary development and management
    State pharmacy license in good standing
    Strong analytical and data interpretation skills
    Excellent communication and negotiation abilities
    Familiarity with healthcare regulations and compliance standards
    Collaboration experience with healthcare providers, payers, and pharmaceutical manufacturers
    Proficiency in utilizing pharmacy management software and tools
    Active participation in relevant professional organizations
    Dedication to staying informed about industry trends and innovations

    Responsibilities:
    Collaborate with healthcare stakeholders to implement and optimize pharmacy benefit programs
    Conduct formulary reviews and assessments to ensure cost-effective and evidence-based medication choices
    Monitor and analyze pharmacy utilization trends, identifying opportunities for cost savings and improved patient outcomes
    Provide expertise in drug utilization management and prior authorization processes
    Stay informed about industry regulations, guidelines, and emerging trends in managed care pharmacy
    If you are a passionate and experienced pharmacist with a background in PBM or Managed Care, we invite you to join our dynamic team dedicated to advancing healthcare through innovative and cost-effective pharmacy solutions. Apply now to contribute to the future of managed care pharmacy.
  • 30 Days Ago

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Managed Care Biller - Centralized Billing Office (CBO)
  • Pursue Health LLC
  • Irvine, CA FULL_TIME
  • Pursue Health, LLC is a rapidly growing company that provides a full spectrum of healthcare consulting and support services to Skilled Nursing Facilities, Hospice Agencies, Out Patient Rehabilitation ...
  • 5 Days Ago

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Care Coordinator Supervisor
  • NEW DIRECTIONS FOR WOMEN INC
  • COASTA MESA, CA OTHER
  • Job Details Job Location: COASTA MESA, CA Position Type: Full Time Salary Range: Undisclosed DescriptionKey Areas of Responsibility: Care Coordinator Team & Operations Team Management Recruitment and ...
  • 7 Days Ago

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RN Clinical Supervisor (Home Health) - Orange County, CA
  • Neogen Care
  • Irvine, CA FULL_TIME
  • * Join Our Team of Highly Talented and Committed Clinical Professionals *This is an exciting opportunity for an upwardly achieving Registered Nurse with management and supervisory experience to take t...
  • 25 Days Ago

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LVN Nurse Supervisor / Urgent Care
  • Impact Solutions Inc
  • Mission Viejo, CA FULL_TIME
  • LVN Nurse Supervisor / Urgent CareMission Viejo, CA75-110K Full Benefits Bonus Paid Relocaton Working under the direction of the Sr. Nurse Manager and/or Site Manager/Director, this position has direc...
  • 2 Days Ago

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Supervisor Respiratory Care *FT/Nights
  • Providence
  • Mission Viejo, CA OTHER
  • DescriptionUnder general supervision, assists department manager in overseeing and directing all aspects of Respiratory Care Services provided on assigned shift. Provides respiratory care services and...
  • 7 Days Ago

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0 Managed Care Supervisor jobs found in Orange, CA area

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Licensed Vocational Nurse (LVN)
  • Glen Park Senior Living
  • Monrovia, CA
  • Job Description Job Description JOB DESCRIPTION: LICENSED VOCATIONAL NURSE (LVN) WELLNESS DIRECTOR POSITION SUMMARY: Uti...
  • 4/19/2024 12:00:00 AM

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Animal Care Supervisor
  • Petco Health and Wellness Company, Inc.
  • Montebello, CA
  • Create a healthier, brighter future for pets, pet parents and people! If you want to make a real difference, create an e...
  • 4/19/2024 12:00:00 AM

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Licensed Psychologist
  • Hiring Now!
  • Orange, CA
  • Thriveworks is currently seeking Licensed Clinicians to provide a mix of telehealth and face-to-face sessions in Irvine,...
  • 4/19/2024 12:00:00 AM

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Fleet (Route) Maintenence Supervisor
  • Penske
  • Orange, CA
  • Responsibilities As a Penske Maintenance Supervisor you will use your excellent communication, organization, and multita...
  • 4/19/2024 12:00:00 AM

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Customer Care Supervisor
  • Marque Urgent Care
  • Irvine, CA
  • Job Description Job Description The Customer Care Center (CCC) at Marque Urgent Care provides consistent, friendly, and ...
  • 4/18/2024 12:00:00 AM

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Online Grocery Pick-Up Clerk
  • Kroger
  • Orange, CA
  • Job Description Select and gather products for customers' on-line orders in the most efficient manner with attention to ...
  • 4/18/2024 12:00:00 AM

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Sr Coordinator Terms and Conditions - Full Time, Days (Bellflower)
  • Prospect Medical Holdings
  • Orange, CA
  • Job Description The Terms and Conditions (T & C) coordinator is responsible for validating pre-load and post-load of con...
  • 4/18/2024 12:00:00 AM

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Care Navigator
  • Brigade Health
  • Orange, CA
  • Overview: We have a great opportunity for a Care Navigator in Orange, CA POSITIONAL SUMMARY: The Care Navigator is respo...
  • 4/8/2024 12:00:00 AM

Orange is a city located in Orange County, California. It is approximately 3 miles (4.8 kilometers) north of the county seat, Santa Ana. Orange is unusual in this region because many of the homes in its Old Town District were built before 1920. While many other cities in the region demolished such houses in the 1960s, Orange decided to preserve them. The small city of Villa Park is surrounded by the city of Orange. The population was 139,812 as of 2014. The city has a total area of 25.2 square miles (65 km2), 24.8 square miles (64 km2) of which is land and 0.4 square miles (1.0 km2) of which i...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Managed Care Supervisor jobs
$84,218 to $116,231
Orange, California area prices
were up 3.0% from a year ago

Managed Care Supervisor in Austin, TX
The F/MCC Supervisor will ensure adequate team staffing, team training, participates in staff hiring and performance reviews.
December 07, 2019
Managed Care Supervisor in Lowell, MA
The individual will have a focus on assessing, interpreting, and analyzing the impact of utilization of services within the Winchester PHO to maximize performance in the managed care contracts that support the BILH Network.
February 18, 2020
Managed Care Supervisor in Montgomery, AL
The hospital offers a full range of medical services including maternity care and a Level IIB Special Care Nursery.
January 15, 2020