The Volunteer State Health Plan, Inc. (VSHP) CHOICES program offers person-centered care planning, service coordination, and support services for members receiving long-term care and home and community based services. The support center supervisor is responsible for providing oversight of the implementation and scheduling of long-term care and home and community based coordination activities conducted by the care coordination team. The support center supervisor ensures timely and accurate delivery of services this includes, but is not limited to management of support center staff, timely implementation of services, accurate entry of authorizations and communication of such to providers, accurate and detailed system documentation, etc.
Job Duties & Responsibilities
- Supervise, direct, and evaluate a diverse group of clinical and non-clinical professionals to assure timely and accurate delivery of services, screenings, TPAES submissions, transition submissions, etc. , which include, but are not limited to, reviewing and approving plans of care while assuring benefits levels are appropriate and have the appropriate approvals, accurate entry of authorizations, accurate and detailed system documentation, appropriate handling of critical incidents maintaining appropriate and ongoing communications and collaborations with FEA, providers, care coordinator supervisors, care coordinator managers, and care coordinators, and reporting quantifiable impact, quality of care, and quality of life improvements as measured against care coordination goals.
- Under the supervision of the operations manager, provide and/or coordinate staff training for maximum performance and provide developmental opportunities.
- Promote teamwork and a positive working environment for the support center team.
- Responsible for communicating and mentoring members of the support center team to ensure long-term and home and community based care guidelines, policies, and procedures are followed.
- Monitor performance of staff including service performance and adherence to established utilization benchmarks.
- May be required periodically to carry case load of members, when dictated by census fluctuations or staffing coverage.
- Other duties deemed necessary for effective and efficient unit operations.
- Registered nurse or Licensed Practical Nurse with an active license in the state of Tennessee or hold a license in the state of their residence if the state is participating in the Nurse Licensure Compact Act; or Masters in Social Work with an active unrestricted license.
- Minimum 2 years of relevant health care experience, preferably in managed and/or long-term care. (see CRA 126.96.36.199.1).
- Minimum 5 years of supervisory/management experience required, operations experience preferred
- 3 years experience providing care coordination to persons receiving long-term care services preferred.
- Excellent communication, leadership, organizational, demonstrates higher-level critical thinking skills and problem prevention skills.
- Exhibits high levels of integrity and ethical behavior
- Demonstrated skills in judgment, critical thinking, diplomacy and positive relationship building
- Ability to deliver and receive feedback in a positive manner
- Demonstrated leadership qualities
- Experience with PC based software programs
- Ability to manage multiple projects and priorities with critical deadlines
BlueCross BlueShield of Tennessee - 2 years ago
BlueCross BlueShield of Tennessee (BCBST) is the oldest and largest not-for-profit managed care provider in the state of Tennessee....