Managed Care Supervisor jobs in Racine, WI

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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RN Care Manager
  • Managed Health Services Wisconsin
  • Racine, WI FULL_TIME
  • You could be the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective on workplace flexibility. * We are currently offering a $5,000 sign-on bonus for this position * ** This hybrid remote role requires less than 50% travel in Milwaukee / Appleton area and candidates will have the flexibility to work remotely from their home the remaining time ** Position Purpose: Perform care management duties to assess, plan and coordinate all aspects of medical and supporting services across the continuum of care for select members to promote quality, cost effective care. • Assess the member's current health status, resource utilization, past and present treatment plan and services, prognosis, short and long term goals, treatment and provider options • Utilize assessment skills and discretionary judgment to develop plan of care based upon assessment with specific objectives, goals and interventions designed to meet member's needs and promote desired outcomes • Coordinate services between Primary Care Physician (PCP), specialists, medical providers, and non-medical staff as necessary to meet the complete medical socio economic needs of clients • Provide patient and provider education • Facilitate member access to community based services • Monitor referrals made to community based organizations, medical care and other services to support the members’ overall care management plan • Actively participate in integrated team care management rounds • Identify related risk management quality concerns and report these scenarios to the appropriate resources. • Case load will reflect heavier weighting of complex cases than Care Manager I, commensurate with experience • Enter and maintain assessments, authorizations, and pertinent clinical information into various medical management systems • Direct care to participating network providers • Perform duties independently, demonstrating advanced understanding of complex care management principles. • Participate in case management committees and work on special projects related to case management as needed Education/Experience: Graduate from an Accredited School of Nursing. Bachelor’s degree in Nursing preferred. 2 years of clinical nursing experience in a clinical, acute care, or community setting and 1 years of case management experience in a managed care setting. Knowledge of utilization management principles and healthcare managed care. Experience with medical decision support tools (i.e. Interqual, NCCN) and government sponsored managed care programs.Licenses/Certifications: Current state’s RN license and a valid driver's license Pay Range: $66,100.00 - $118,900.00 per year Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law. Total compensation may also include additional forms of incentives. Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.

    About the Company:
    Managed Health Services Wisconsin



  • 1 Month Ago

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Care Manager II (RN) - Now Hiring
  • Managed Health Services WI
  • Kansasville, WI FULL_TIME
  • You could be the one who changes everything for our 26 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offeri...
  • 8 Days Ago

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Nurse Supervisor RN
  • Quality Care LTC
  • Pleasant Prairie, WI FULL_TIME
  • Waters Edge Health and Rehab has an exciting opportunity for a driven leader to join our growing team as a Nurse Supervisor RN in Kenosha, WI. This position will work alongside a phenomenal Director o...
  • 12 Days Ago

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Animal Care Supervisor
  • Petco
  • Crystal, IL FULL_TIME
  • Create a healthier, brighter future for pets, pet parents and people! If you want to make a real difference, create an exciting career path, feel welcome to be your whole self and nurture your wellbei...
  • 22 Days Ago

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Resident Care Supervisor
  • State of Wisconsin
  • Union Grove, WI FULL_TIME
  • Introduction The Department of Health Services (DHS), Southern Wisconsin Center (SWC) is recruiting for a Resident Care Supervisor. Work hours are: First Shift – 6:45 AM – 3:15 PM, Second Shift - 2:45...
  • Just Posted

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Resident Care Supervisor
  • Wisconsin Department of Health Services
  • Union Grove, WI FULL_TIME
  • Introduction The Department of Health Services (DHS), Southern Wisconsin Center (SWC) is recruiting for a Resident Care Supervisor. Work hours are: First Shift – 6:45 AM – 3:15 PM, Second Shift - 2:45...
  • Just Posted

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0 Managed Care Supervisor jobs found in Racine, WI area

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Resident Assistant
  • CM Homes
  • Racine, WI
  • Job Description Job Description RESIDENT ASSISTANT: CONTRACT POSITION 2nd Shift- 3p-11p (every other weekend and holiday...
  • 4/26/2024 12:00:00 AM

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Caregiver
  • Eden Senior Care
  • Racine, WI
  • Job Description Eden Senior Care, founded in 2016, is a growing Healthcare Management company, focused on managing and o...
  • 4/26/2024 12:00:00 AM

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Behavior Technician - School
  • Amergis
  • Racine, WI
  • $20 - $25 The Behavior Technician works to facilitate educational andbehavioral services with children and adults with s...
  • 4/26/2024 12:00:00 AM

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Cashier
  • Walmart
  • Racine, WI
  • Job Description **Overview:** As a Walmart Cashier, you play a crucial role in providing exceptional customer service wh...
  • 4/24/2024 12:00:00 AM

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Picker / Packer
  • Walmart
  • Racine, WI
  • **Job Title: Picker/Packer** **Job Summary:** As a Picker/Packer at Walmart, you will play a critical role in the fulfil...
  • 4/24/2024 12:00:00 AM

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Sanitarian
  • City of Racine (WI)
  • Racine, WI
  • Job Description We offer a great benefits package including medical, dental, pension program, HSA, and generous time off...
  • 4/23/2024 12:00:00 AM

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RN Case Management
  • Ascension
  • Racine, WI
  • Details Department: Case Management Schedule: Full Time, Evening Shift Hospital: All Saints Spring St Location: Racine, ...
  • 4/23/2024 12:00:00 AM

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Plant Associate
  • Stericycle Inc.
  • Sturtevant, WI
  • Title: Plant Associate Requisition Id: 33412 Job Function: Plant/Processing Operations Career Area: Operations Work Loca...
  • 4/22/2024 12:00:00 AM

Racine (/rəˈsiːn/ rə-SEEN) is a city in and the county seat of Racine County, Wisconsin, United States. It is located on the shore of Lake Michigan at the mouth of the Root River. Racine is located 22 miles south of Milwaukee. As of the 2010 U.S. census, the city had a population of 78,860, making it the fifth-largest city in Wisconsin. Its median home price of $103,625 makes it one of the most affordable cities in Wisconsin to buy a home. In January 2017, it was rated "the most affordable place to live in the world" by the Demographia International Housing Affordability survey. Racine is th...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Managed Care Supervisor jobs
$74,167 to $102,359
Racine, Wisconsin area prices
were up 1.8% from a year ago

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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