Bravo Health is a premier provider of managed care services for people with Medicaid. We value service, trust, discipline, innovation, teamwork and integrity above all else.
Ready for a challenge? If you are a hard-working, career-minded associate with a commitment to service and quality, we would love to consider you for a career opportunity as an Manager, Field Service Coordination in Bedford, Texas..
Work in partnership with the Director, Service Coordination to develop and execute field-based service coordination activities to improve the health of special needs members; to facilitate high quality, cost effective outcomes and minimize fragmentation of health care delivery. The Manager also coordinates with and supports UM, quality improvement and compliance activities related to service coordination in the STAR+PLUS program.
DUTIES AND RESPONSIBILITIES:
- Leadership: Manage a team of field-based nursing staff. Further the goals and objectives of the department, health plan and Company. Assign work through matrix structures as necessary. Review analyses of activities, costs, operations and forecast data to determine progress toward stated goals and objectives.
- Significant Duties: Assure compliance with established service coordination, referral, pre-certification and authorization policies, procedures and processes. Assist staff with the resolution of issues related to the service coordination function. Ensure staff safety and productivity in the field.
- Methods and Procedures: Collaborate to develop, implement and maintain policies and procedures regarding service coordination functions
- Performance Standards and Measures: Facilitate the use of appropriate medical resources, decrease health plan financial exposure, and create performance standards. Conduct field-based audits and staff assessments.
- Reports: Collaborate to compile and review reports to identify utilization trends, assist in financial forecasting, and make recommendations to management. Use reports to manage team activities.
- Communication/Liaison: Facilitate on-going communication between service coordination, health plan staff and providers.
- People Management: Develop staff skills and competencies through structured training and day-to-day interactions. Hire new staff. Coach and mentor. Lead by example to create desired culture and motivated people in organization.
- ISP oversight: Assure compliance with cost guidelines for ISP development. Evaluate exceptions for medical necessity. Elevate to Medical Director for medical necessity review of potential denial of waiver services
- Case Load Management: Monitor and adjust caseloads as needed. Monitor Service coordinator's caseloads for timeliness of assessment, efficient time management and accuracy and completeness of service plan development and documentation
At Bravo Health, we recognize and reward your knowledge, skills, experience and dedication to excellence with attractive compensation plans and an impressive benefits package that includes:
- Registered Nurse with an active TX license, BSN with MHA, MPH or related degree preferred
- 5 – 7 years of managed care or insurance industry experience, at least 2 years of management experience, hands-on STAR+Plus experience
- Effective oral, written, excellent interpersonal communication and problem solving skills
- Strong organizational and time management skills
- Ability to analyze data and employ approved management techniques and statistical tools to obtain maximum effectiveness, efficiency, and information.
- Ability to utilize continuous quality improvement, techniques, and tools in all aspects of the position.
- Ability to align all work and resource management with Bravo Health’s mission, vision, philosophies, and values, as well as with its goals and strategic imperatives.
- Substantial knowledge of Microsoft Office including SharePoint, Outlook, PowerPoint, Excel and Word.
If you are interested in learning more about how you can become part of our dynamic, high-growth organization that provides opportunities for our members and our employees to “Live Life Well”, we encourage you apply today.
- Medical and dental insurance along with prescription and vision coverage
- Immediate participation in a 401K plan with a company match that is 100% vested from day one.
- A generous tuition reimbursement plan
- Company-paid, life and AD&D insurance as well as company-paid short-term and long-term disability coverage.
- Considerable Paid-Time-Off
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