Managed Care Supervisor jobs in Somerset, NJ

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 Specialist
  • Everest National Insurance Company
  • Warren, NJ FULL_TIME
  • Title: Managed Care Specialist Company: Everest Insurance Company Job Category: Claims Job Description: Everest Group, a NYSE listed S&P 500, is a leading global reinsurance and insurance provider, operating for nearly 50 years, now in over 15 countries. Everest is a growth company offering Property, Casualty and Specialty products. We have extensive product and distribution capabilities backed by a strong balance sheet which is evident in our Financial Agency Ratings of: A A. M. Best, A S&P Global and A1 Moody’s Investor Service. We take pride in being known in the industry as nimble, entrepreneurial and responsive. Our culture is innovative, we empower our employees to make business decisions within our risk framework at a local level. At Everest, we are committed to the development of our people. We offer dynamic training & professional development to our employees. You will benefit from career development and learning opportunities that will let you set career goals and fulfill them, including: • Generous tuition/continuing education reimbursement • Mentoring opportunities • Flexible work arrangements • Talent development initiatives • Networking groups PRIMARY PURPOSE: Analyze complex or technically difficult managed care issues to positively impact overall medical costs for all Everest Insurance workers’ compensation business. Provide analytics, strategy and execution for maximum medical cost savings, ensure ongoing adjudications within company claim best practice standards, industry best practices and specific Everest Insurance service instructions; perform analysis of medical bills and data analytics. ESSENTIAL FUNCTIONS and RESPONSIBILITIES: Analyze workers’ compensation costs for reducing medical exposure Develop and manage cost driver action plans Assist in the expansion of managed care services nationally Provide medical management expertise for complex cases Present at internal training workshops Provide excellent customer service internally and externally Conduct ongoing assessment of managed care vendors for optimum performance and medical cost savings Focus on innovation, creativity, original thinking and resourcefulness to achieve financial results Ability to work independently or as a co-leader of various task teams, thrive on change, and have vision for supporting company growth and profitability EXPERIENCE SKILLS and KNOWLEDGE: Five years plus workers’ compensation managed care experience Experience with multi-state fee schedule, inpatient facility and PPO contracts Computer proficiency in all Microsoft Office products with a strong emphasis on Excel In depth knowledge of state workers’ compensation laws Bill review knowledge preferred Excellent oral & written skills Analytical & interpretive skills; excellent judgment, troubleshooting, problem solving skills Ability to handle multiple tasks and deadlines EDUCATION: Bachelor’s Degree from an accredited college or university For CA only: The base salary range for this position is $100,000 - $115,000 annually. The offered rate of compensation will be based on individual education, experience, qualifications and work location. Our Culture At Everest, our purpose is to provide the world with protection. We help clients and businesses thrive, fuel global economies, and create sustainable value for our colleagues, shareholders and the communities that we serve. We also pride ourselves on having a unique and inclusive culture which is driven by a unified set of values and behaviors. Click here to learn more about our culture. Our Values are the guiding principles that inform our decisions, actions and behaviors. They are an expression of our culture and an integral part of how we work: Talent. Thoughtful assumption of risk. Execution. Efficiency. Humility. Leadership. Collaboration. Diversity, Equity and Inclusion. Our Colleague Behaviors define how we operate and interact with each other no matter our location, level or function: Respect everyone. Pursue better. Lead by example. Own our outcomes. Win together. All colleagues are held accountable to upholding and supporting our values and behaviors across the company. This includes day to day interactions with fellow colleagues, and the global communities we serve. #LI-Hybrid #LI-CK1 Type: Regular Time Type: Full time Primary Location: Warren, NJ Additional Locations: Walnut Creek, CA Everest is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion or creed, sex (including pregnancy), sexual orientation, gender identity or expression, national origin or ancestry, citizenship, genetics, physical or mental disability, age, marital status, civil union status, family or parental status, veteran status, or any other characteristic protected by law. As part of this commitment, Everest will ensure that persons with disabilities are provided reasonable accommodations. If reasonable accommodation is needed to participate in the job application or interview process, to perform essential job functions, and/or to receive other benefits and privileges of employment, please contact Everest Benefits at everestbenefits@everestglobal.com. Everest U.S. Privacy Notice | Everest (everestglobal.com) EVEREST is a leading international reinsurance and insurance group with an extensive distribution network that spans five continents. With roots dating back to 1973, Everest has developed a global footprint and deep client relationships that are largely unmatched by its peers. The Company’s principal business strategies seek to leverage its strengths to optimize returns over the underwriting cycle, thereby creating value for its shareholders and business partners.
  • 1 Month Ago

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Nursing Supervisor
  • Hunterdon Care Center
  • Flemington, NJ PART_TIME
  • 185-bed Skilled Nursing Facility looking for a full time Nursing Supervisor for the evening shift (12:00am-8:30am) Monday through Friday. Proper candidates should possess a current NJ RN License and n...
  • 2 Months Ago

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Clinical Supervisor
  • Stress Care of New Jersey, LLC
  • Somerset, NJ FULL_TIME
  • Stress Care of New Jersey is a JCAHO certified outpatient mental health and substance Abuse treatment center licensed with the New Jersey Department of Human Services and Accredited by the Joint Commi...
  • 14 Days Ago

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(RN) Registered Nurse Weekend Supervisor
  • Complete Care Management
  • Newton, NJ FULL_TIME
  • BALANCE WORK AND HOME! NOW HIRING: RN Supervisor: Weekend 12 HOUR SHIFTS 12 HOUR SHIFTS: 7AM - 7PM BE YOUR BEST! ASK ABOUT OUR GREAT RATES AND SIGN ON BONUS!! Share your talent. Feel recognized and ap...
  • 14 Days Ago

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(RN) Registered Nurse Weekend Supervisor
  • Complete Care at Barn Hill
  • Newton, NJ FULL_TIME
  • BALANCE WORK AND HOME! NOW HIRING: (RN) REGISTERED NURSE - WEEKENDS 12 HOUR SHIFTS: 7AM - 7PM / 7PM - 7AM BE YOUR BEST! ASK ABOUT OUR GREAT RATES AND SIGN ON BONUS!! Share your talent. Feel recognized...
  • 1 Month Ago

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Registered Nurse (RN) 3-11 Supervisor
  • Rolling Hills Care Center
  • Lebanon, NJ FULL_TIME
  • Rolling Hills Care Center, sub-acute and long-term care facility located in Lebanon, NJ is seeking a Registered Nurse ( RN)-3-11 Nurse Supervisor who manages the nursing employees on the nursing units...
  • 1 Month Ago

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0 Managed Care Supervisor jobs found in Somerset, NJ area

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Animal Care Supervisor
  • Petco Animal Supplies, Inc.
  • Piscataway, NJ
  • Create a healthier, brighter future for pets, pet parents and people! If you want to make a real difference, create an e...
  • 4/22/2024 12:00:00 AM

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Animal Care Supervisor
  • Petco Health and Wellness Company, Inc.
  • Milltown, NJ
  • Create a healthier, brighter future for pets, pet parents and people! If you want to make a real difference, create an e...
  • 4/21/2024 12:00:00 AM

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Animal Care Supervisor
  • Petco Animal Supplies, Inc.
  • Milltown, NJ
  • Create a healthier, brighter future for pets, pet parents and people! If you want to make a real difference, create an e...
  • 4/21/2024 12:00:00 AM

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Supervisor - Facilities - Maintenance & Trades - Evenings
  • NewYork-Presbyterian Hospital
  • Flushing, NY
  • Location Queens, New York Shift: Evening (United States of America) Description: Facilities For Best-In-Class Care Super...
  • 4/21/2024 12:00:00 AM

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New Brunswick, NJ - YoungLives Coordinator
  • Young Life
  • New Brunswick, NJ
  • Description: Young Life in the Brunswicks (New Brunswick, NJ) is seeking an innovative, driven, and faithful individual ...
  • 4/21/2024 12:00:00 AM

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Animal Care Supervisor
  • Petco Health and Wellness Company, Inc.
  • Eatontown, NJ
  • Create a healthier, brighter future for pets, pet parents and people! If you want to make a real difference, create an e...
  • 4/20/2024 12:00:00 AM

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Pet Care Supervisor
  • K9 Resorts of Fanwood
  • Fanwood, NJ
  • Job Description Job Description K9 Resorts & Luxury Hotel is currently seeking Kennel Technicians. This position offers ...
  • 4/19/2024 12:00:00 AM

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Coordinator Scheduling Staffing Home Care Bilingual
  • Bestcare, Inc
  • New York, NY
  • Job Description Job Description Staffing/Service Coordinator Home Care Bilingual English/Spanish Our Coordinators are a ...
  • 4/18/2024 12:00:00 AM

Somerset is an unincorporated community and census-designated place (CDP) located within Franklin Township, in Somerset County, New Jersey, United States. As of the 2010 United States Census, the CDP's population was 22,083. Somerset housed one of the first Marconi Wireless Stations in the United States. According to the United States Census Bureau, the CDP had a total area of 6.444 square miles (16.692 km2), including 6.327 square miles (16.388 km2) of land and 0.117 square miles (0.304 km2) of water (1.82%)....
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Managed Care Supervisor jobs
$85,589 to $118,122
Somerset, New Jersey area prices
were up 1.5% 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