Supervisor-PHP Clinical Operations

Overview:

Now hiring a Supervisor-PHP Clinical Operations

Assists the Manager and Director to apply performance measurements

and/or ensure that the level of care and services requested meet quality of care standards. Conducts direct departmental duties as needed.

How you belong matters here.

We value our employees' differences and find strength in the diversity of our team and community.

At Presbyterian, it's not just what we do that matters. It's how we do it - and it starts with our incredible team. From Information Technology to Food Services and beyond, our non-clinical employees make a meaningful impact on the healthcare provided to our patients and members.

• Full Time - Exempt: Yes
• Job is based Rev Hugh Cooper Admin Center
• Work hours: Days
• Benefits: We offer a wide range of benefits including medical, wellness program, vision, dental, paid time off, retirement and more for FT employees.

Qualifications:

• Bachelors degree and 3 years of healthcare related experience required.
• BSN with active RN License or Bachelors degree in health care specialty preferred.
• Demonstrated management leadership skills.
• Must have valid drivers license, clean driving record and ability to travel regionally.

Responsibilities:

• Supervises daily workflow functions related to applicable PHP departmental activities, including but not limited to the identification and screening for appropriateness of request for services.
• Ensures staff is in compliance with regulatory and state entities such as HSD, DOI, and NCQA relative to all activities associated with the care of members.
• Monitors staff case load and distributes work flow to meet timeliness of service.
• Trains staff in departmental application of benefits, processes, policies and procedures, and assist in training of computer activities.
• Performs departmental activities including but not limited to: assessments, Plan of care development, motivational interviewing, member education, and evaluation of member services.
• Mentors staff in applicable principles and decision-making skills.
• Prepares reports as requested.
• Assist Manager and Director in compliance with regulatory requirements and participates as indicated in audits or surveys by accrediting or oversight agencies.
• Works with providers to educate and assist with applicable processes.
• May work with Manager and Director in review of cost analysis of medical expenses.
• Supports implementation of change projects/initiatives. Supports the development and implementation of the department strategic plan.
• Acts as a resource for policies, procedures, and operational changes within the unit.
• Participates in selection, training, and orientation of new employees.
• Performs other functions as required.

Benefits:

All benefits-eligible Presbyterian employees receive a comprehensive benefits package that includes medical, dental, vision, short-term and long-term disability, group term life insurance and other optional voluntary benefits.

Wellness

Presbyterian's Employee Wellness rewards program is designed to provide you with engaging opportunities to enhance your health and activate your well-being. Earn gift cards and more by taking an active role in our personal well-being by participating in wellness activities like wellness challenges, webinar, preventive screening and more.

As an organization, we are committed to improving the health of our communities. From hosting growers' markets to partnering with local communities, Presbyterian is taking active steps to improve the health of New Mexicans.

About Presbyterian Healthcare Services

Presbyterian exists to improve the health of patients, members, and the communities we serve. We are locally owned, not-for-profit healthcare system of nine hospitals, a statewide health plan and a growing multi-specialty medical group. Founded in New Mexico in 1908, we are the state's largest private employer with nearly 14,000 employees - including more than 1600 providers and nearly 4,700 nurses.

Our health plan serves more than 580,000 members statewide and offers Medicare Advantage, Medicaid (Centennial Care) and Commercial health plans.

Inclusion and Diversity

Our culture is one of knowing and respecting our patients, members, and each other. We capture this in our Promise and CARES commitments.

AA/EOE/VET/DISABLED. PHS is a drug-free and tobacco-free employer with smoke free campuses.

Maximum Offer for this position is up to: USD $51.41/Hr.

The compensation range for this role takes into account a wide range of factors, including but not limited to experience and training, internal equity, and other business and organizational needs.