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 & Tools
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