Managed Care Supervisor jobs in Richmond, VA

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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Managed Care Coordinator
  • Elevance Health
  • Chesterfield, VA FULL_TIME
    • Job Family: Medical and Clinical
    • Type: Full time
    • Date Posted: Feb 23, 2024
    • Anticipated End Date: Mar 31, 2024
    • Reference: JR107137

    Description

    Managed Care Coordinator

    MUST LIVE WITHIN THE CENTRAL , VA AREA

    (Brunswick, Charlotte, Chesterfield, Halifax, Petersburg, Sussex, Richmond City, VA)

    A proud member of the Elevance Health family of companies, Carelon Behavioral Health, formerly Beacon Health Options, offers superior clinical mental health and substance use disorder management, a comprehensive employee assistance program, work/life support, specialty programs for autism and depression, and insightful analytics to improve the delivery of care.

    The Managed Care Coordinator is responsible for overall management of member's individual service plan within the scope of position, as required by applicable state law and contract.

    How you will make an impact:

    • Performing telephonic or face-to-face history and program needs assessments using a tool with pre-defined questions for the identification, evaluation, coordination and management of member's program needs.
    • Using tools and pre-defined identification process, identifies members with potential clinical health care needs (including, but not limited to, potential for high risk complications) and coordinates those member's cases with the clinical healthcare management and interdisciplinary team in order to provide care coordination support.
    • The process does not involve clinical judgment; however, some working knowledge of the American Society of Addiction Medicine (ASAM) Criteria is preferred.
    • Manages non-clinical needs of members with chronic illnesses, co-morbidities, and/or disabilities, to insure cost effective and efficient utilization of services.
    • Establishes short and long term goals in collaboration with the member, caregivers, family, natural supports, and physicians. Identifies members that would benefit from expanded services.
    • Travels to worksite and other locations as necessary.

    Minimum Requirements:

    • Requires BA/BS degree
    • A minimum of 1 year of experience working directly with people related to the specific program population or other related community based organizations; or any combination of education and experience which would provide an equivalent background.

    Preferred Skills, Capabilities, and Experiences:

    • For MMP, requires Community Health Worker certification to be obtained within one year of employment.
    • Bachelors / Masters degree in a health or human service field. .
    • BA/BS degree field of study in health care related field preferred.
    • QMHP certification / or CSAC certification highly preferred.
    • 1 year of experience working directly with individuals with substance use disorder highly preferred..
    • Specific education and years and type of experience may be required based upon state law and contract requirements.
    • LMHP, RN/LPN field of study preferred.
    • Behavioral/Mental Health experience


    Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.

    Who We Are

    Elevance Health is a health company dedicated to improving lives and communities – and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.

    How We Work

    At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business.

    We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.

    Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process. Candidates must reside within 50 miles or 1-hour commute each way of a relevant Elevance Health location.

    The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws.

    Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact elevancehealthjobssupport@elevancehealth.comfor assistance.

  • 1 Month Ago

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Nursing Supervisor
  • Option Care Enterprises, Inc.
  • Richmond, VA FULL_TIME
  • Delivering an exceptional infusion experience, everywhere. Delivering on our unyielding commitment, always. Naven Health is a nationwide home infusion nursing network and clinical platform focused on ...
  • 17 Days Ago

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LPN - Supervisor
  • Autumn Care of Madison
  • Madison, VA FULL_TIME
  • Caring is at the heart of everything! Working in long term care offers many rewards you can’t find anywhere else. From the relationships you develop to the sense of pride you feel when you help others...
  • 1 Month Ago

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Managed Print Services Coordinator
  • Networking Technologies + Support
  • Midlothian, VA FULL_TIME
  • Managed Print Services Coordinator Job Code: 808 # of Openings: 1 Description NTS IS HIRING A FULL-TIME MANAGED PRINT SERVICES COORDINATOR. Are you a dynamic individual who's passionate about not just...
  • 3 Days Ago

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RN Weekend Supervisor
  • Autumn Care of Mechanicsville
  • Mechanicsville, VA FULL_TIME
  • Are you an experienced Registered Nurse (RN) Supervisor looking to make a difference? We are a leader in the long-term care industry operating in 6 different states. It is our commitment to the care o...
  • Just Posted

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RN Weekend Supervisor
  • Autumn Care of Mechanicsville
  • Mechanicsville, VA FULL_TIME
  • Are you an experienced Registered Nurse (RN) Supervisor looking to make a difference? We are a leader in the long-term care industry operating in 6 different states. It is our commitment to the care o...
  • 5 Days Ago

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0 Managed Care Supervisor jobs found in Richmond, VA area

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Heavy Equipment Mechanic
  • Altec Industries , Inc.
  • Richmond, VA
  • Why Join Altec? Strong in spirit and industry knowledge, Altec mechanics are the best in the industry. If you are a care...
  • 3/29/2024 12:00:00 AM

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Research Psychologist F72790- Department of Psychiatry
  • Virginia Commonwealth University
  • Richmond, VA
  • Mission or Goal of Unit: The mission of the Department of Psychiatry is to improve the mental health of individuals andf...
  • 3/29/2024 12:00:00 AM

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Clinician I Assertive Community Treatment (ACT) *SIGN ON BONUS ELIGIBLE*
  • Richmond Behavioral Health Authority
  • Richmond, VA
  • Description RBH is now offering sign-on bonus opportunities for qualifying professionals! Assertive Community Treatment ...
  • 3/29/2024 12:00:00 AM

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LTAC/Med Surg RN - Weekly pay! (Days)
  • Maxim Healthcare Staffing
  • Richmond, VA
  • The Critical Care Registered Nurse assumes responsibility and accountability for the application of the nursing process ...
  • 3/29/2024 12:00:00 AM

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MRI Supervisor - Specialist Team - Radiology MRI
  • VCU Health
  • Richmond, VA
  • The Radiology Technologist Supervisor-Specialist Team provide day-to-day supervision for an assigned Radiology area (e.g...
  • 3/29/2024 12:00:00 AM

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Nurse Supervisor
  • Waverly Rehabilitation and Healthcare Center
  • Richmond, VA
  • Waverly Rehabilitation and Healthcare Center - Waverly Rehabilitation And Healthcare Center, located in Waverly, VA, is ...
  • 3/29/2024 12:00:00 AM

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Travel Physical Therapist - Explore ATI
  • Ati Physical Therapy
  • Richmond, VA
  • Overview: As a licensed Physical Therapist, you are responsible for the evaluation and treatment of patients, establishi...
  • 3/29/2024 12:00:00 AM

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Home Care Clinical Supervisor
  • BAYADA Home Health Care
  • Richmond, VA
  • BAYADA Home Health Care is seeking a Clinical Manager (RN required) for our Richmond, VA Assistive Care home care office...
  • 3/29/2024 12:00:00 AM

Richmond (/ˈrɪtʃmənd/) is the capital of the Commonwealth of Virginia in the United States. It is the center of the Richmond Metropolitan Statistical Area (MSA) and the Greater Richmond Region. Richmond was incorporated in 1742 and has been an independent city since 1871. As of the 2010 census, the city's population was 204,214; in 2016, the population was estimated to be 223,170, making Richmond the fourth-most populous city in Virginia. The Richmond Metropolitan Area has a population of 1,260,029, the third-most populous metro in the state. Richmond is located at the fall line of the James R...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Managed Care Supervisor jobs
$75,580 to $104,312
Richmond, Virginia area prices
were up 1.2% from a year ago

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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.
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Managed Care Supervisor in Montgomery, AL
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