Supervisor, Clinical Operations Oversight
Centene Corporation
full-time
Posted on:
Location Type: Remote
Location: Arizona • United States
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Salary
💰 $56,200 - $101,000 per year
About the role
- Lead the implementation of new auditing processes and staffing oversight for audits of specific Utilization Management, Care Management Appeals activities within the organization
- Provides guidance and oversight support of corrections identified by Utilization Management, Care Management, and/or Appeals leadership along with Compliance Officers regarding the requirements of accrediting and regulatory agencies
- Leads the daily operations management of associates who monitor compliance through business monitoring audits, staff performance quality audits, surveillance and defect reports
- Coordinates monthly and quarterly audit and business monitoring results to provide systemic results and highlight opportunities for improvement
- Ensures team is operating at high standards with minimal overturn of results based on internal standards
- Implements audit programs to ensure compliance with all operational processes
- Provides feedback to leadership team regarding audit results, opportunities for improvement, and/or required Corrective Action Plans
- Leads Monitoring Teams responsible for research, education and conducts audits
Requirements
- Bachelor's Degree in Health Care related field, or related work experience
- 4+ years of regulatory, audit, oversight or healthcare delivery required
- Previous leadership, senior mentorship experience including responsibilities for hiring, training, assigning work and managing performance of staff preferred
- Clinical licensure (RN) if managing team with RNs or LWCS/MSW LMHC licensure if leading team of Behavioral Health Professionals
Benefits
- competitive pay
- health insurance
- 401K and stock purchase plans
- tuition reimbursement
- paid time off plus holidays
- flexible approach to work with remote, hybrid, field or office work schedules
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard skills
auditing processescompliance monitoringbusiness monitoring auditsperformance quality auditsaudit programsCorrective Action Plansstaff performance managementresearcheducationsystemic results analysis
Soft skills
leadershipmentorshipguidanceoversightcommunicationteam managementperformance managementopportunity identificationfeedback provisionorganizational skills
Certifications
Bachelor's Degree in Health CareRN licensureLWCS licensureMSW licensureLMHC licensure