Managed Care Supervisor jobs in Philadelphia, PA

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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MOMobile Managed Care Program Manager
  • Maternity Care Coalition
  • Philadelphia, PA FULL_TIME
  • Organizational Summary

    In 1980, a group of Philadelphia health and social justice activists came together over concerns about the well-being of pregnant people and infants. They created Maternity Care Coalition (MCC) and advocated for change with policymakers and decision makers.


    Today, we continue to center children and their families by supporting, referring, educating, researching, and advocating.


    Position Summary
    Responsible for day-to-day operations of the MOMobile Managed Care program. Provides leadership in conducting outreach, follow-up, and home visiting to identify pregnant women and families with young children and provide appropriate services.

    Benefits include:
    • Three (3) weeks paid vacation, plus One (1) week paid Winter Break
    • Medical, Dental, Vision, Voluntary & Supplemental Life Insurance through CIGNA
    • Cafeteria Plan through Benefit Wallet: FSA and Commuter plans

    Essential Functions

    • Manages and monitors all MOMobile Managed Care activities and ensures quality of services.
    • Provides supervision to managed care advocates and student intern(s).
    • Responsible for recruitment and hiring of managed care advocates.
    • Acts as a community liaison between MCC, clients, and Medicaid managed care organizations (MCOs) and manages referrals from MCO partners.
    • Routinely communicates with MCO providers and schedules monthly/bi-monthly check-in meetings.
    • Oversees the contract scope of services with MCO partners.
    • Prepares and submits all reports and invoices as required by funders.
    • Develops and monitors program budgets and spending.
    • Communicates and coordinates contract requirements with other MCC program managers.
    • Facilitates regular staff meetings and conducts individual supervisory meetings.
    • Conducts regular home visit observations.
    • Provides direct services to a small caseload when needed.
    • Regularly reviews client files and provides feedback to staff.
    • Prepares performance evaluations with input from staff.
    • Identifies staff training needs and writes yearly training plans.
    • May be required to travel the eight-county region

    Other Tasks

    • Adheres to the MCC’s security guidelines and ensures the appropriate handling of sensitive information.
    • Attends relevant staff meetings to promote communication and execution of goals.
    • Completes special projects specific to the function of the department or as needed for the department as directed by the supervisor.
    • Other duties as assigned within the scope of position expectations.

    Knowledge, Skills, and Abilities

    • Understanding of MCC’s mission, goals, and objectives and ability to work independently with a high level of energy and contribute as part of a larger team.
    • Knowledge of the concepts and practices associated with community health issues, particularly with pregnant women, prenatal care, parenting and other services for mothers, young children, and their families.
    • Ability to travel in and around the Greater Philadelphia region to conduct home visits and community outreach.
    • Knowledge of and sensitivity to issues facing the community served.
    • Experience in client management procedures for determining eligibility, assessing needs, identifying resources, making referrals, following up, and documenting client interactions.
    • Demonstrated clinical social work skills.
    • Strong interpersonal skills as demonstrated by compassionate, courteous, cordial, cooperative, and professional interaction with diverse groups of co-workers, community partners, clients, and members of the community.
    • Ability to operate a computer and use a variety of common software programs including Microsoft Office, spreadsheets, and customized databases.
    • Effective and accurate documentation of case notes and client data according to established client management documentation procedures.
    • Ability to organize tasks in an efficient manner and follow-up and follow-through with strong attention to detail.
    • Proficient with Microsoft Office Suite, ability to operate a computer and use a variety of common software programs a must
    • Experience utilizing virtual meeting platforms
    • This is a telecommuting position. Staff are required to be onsite at least (1) day a week (you can add your requirement). In addition, staff must establish a safe and supportive workspace at home.

    Experience, Education, and Licensure

    • Master’s degree in social work or related field strongly preferred; bachelor’s degree required.
    • 2 years of supervisory experience preferred
    • Valid driver’s license
  • 17 Days Ago

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PBM / Managed Care Pharmacist
  • Pharmacy Careers
  • Philadelphia, PA 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 medicatio...
  • 1 Month Ago

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Care supervisor
  • ComForCare Home Care - North Montgomery County
  • Lansdale, PA FULL_TIME
  • Benefits : Bonus based on performance Competitive salary Flexible schedule Paid time off Wellness resources Full job description At ComForCare Home Care we value our employees like family. We celebrat...
  • Just Posted

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Clinical Care Supervisor
  • Angels of Care Pediatric Home Health
  • Springfield, PA FULL_TIME
  • Join our team as a Clinical Care Supervisor with a Registered Nurse (RN) license for a growing company that has a huge HEART! Work with passionate, talented professionals that are dedicated to serving...
  • 6 Days Ago

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Clinical Care Supervisor
  • Angels of Care Pediatric Home Health
  • Springfield, PA FULL_TIME
  • Join our team as a Clinical Care Supervisor with a Registered Nurse (RN) license for a growing company that has a huge HEART! Work with passionate, talented professionals that are dedicated to serving...
  • 6 Days Ago

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Managed consultant
  • Veeva
  • Philadelphia, PA FULL_TIME
  • Veeva Systems is a mission-driven organization and pioneer in industry cloud, helping life sciences companies bring therapies to patients faster. As one of the fastest-growing SaaS companies in histor...
  • 3 Days Ago

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0 Managed Care Supervisor jobs found in Philadelphia, PA area

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Public Safety Program Executive Director - Salary Range: $105,000-118,650
  • City of Philadelphia
  • Philadelphia, PA
  • Company Description A best-in-class city that attracts best-in-class talent, Philadelphia is an incredible place to buil...
  • 4/25/2024 12:00:00 AM

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House Supervisor RN
  • Mission Regional Medical center
  • Philadelphia, PA
  • Overview Join an award-winning team of dedicated professionals committed to our core values of quality, compassion and c...
  • 4/24/2024 12:00:00 AM

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Hospital Aide I
  • Good Shepherd Rehab
  • Philadelphia, PA
  • * JOB SUMMARY * Assists in patient care and related activities as instructed by the physical therapist, physical therapi...
  • 4/24/2024 12:00:00 AM

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Team Leader - Philadelphia Fashion District
  • Primark
  • Philadelphia, PA
  • Job Description Team Leader Because you don't just succeed - you exceed. Retail our way. A people-first culture. Inclusi...
  • 4/24/2024 12:00:00 AM

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Personal Care Worker
  • Trinity Health Corporation
  • Philadelphia, PA
  • Employment Type: Full time Shift: Night Shift Description: Personal Care Worker Location: Mercy LIFE West Philadelphia, ...
  • 4/24/2024 12:00:00 AM

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RN - Registered Nurse (Pediatrics) Sign on Bonus!
  • Pediatric Specialty Care
  • Philadelphia, PA
  • Salary: $38.00/hour - $53.20/hour Overview: Pediatric Specialty Care in Philadelphia, PA is seeking dedicated and compas...
  • 4/23/2024 12:00:00 AM

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Operations Supervisor
  • LIVE NATION ENTERTAINMENT INC
  • Philadelphia, PA
  • Job Summary: WHO ARE WE? Live Nation Entertainment is the world's leading live entertainment company, comprised of globa...
  • 4/23/2024 12:00:00 AM

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Licensed Psychologist
  • Thriveworks
  • Philadelphia, PA
  • Thriveworks is currently seeking Licensed Clinicians to provide a mix of telehealth and face-to-face sessions in Philade...
  • 4/21/2024 12:00:00 AM

Philadelphia, sometimes known colloquially as Philly, is the largest city in the U.S. state and Commonwealth of Pennsylvania, and the sixth-most populous U.S. city, with a 2017 census-estimated population of 1,580,863. Since 1854, the city has been coterminous with Philadelphia County, the most populous county in Pennsylvania and the urban core of the eighth-largest U.S. metropolitan statistical area, with over 6 million residents as of 2017[update]. Philadelphia is also the economic and cultural anchor of the greater Delaware Valley, located along the lower Delaware and Schuylkill Rivers, wit...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Managed Care Supervisor jobs
$80,411 to $110,976
Philadelphia, Pennsylvania area prices
were up 1.0% 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