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Supervisor, Medical Management Operations

Overview

The Supervisor, Medical management Operations (Supervisor) will supervise and coordinate the day-to-day business operations of clinical and non clinical support activities, including monitoring internal processes, coordinating activities between the clinical and non-clincal staff, and supervising support functions to facilitate efficient clinical operations. He/she will also makes recommendations on operational improvements for the department.


Responsibilities
  • Supervises the day-to-day operations of CHOICE Medical Management clinical and non clinical staff.  Makes recommendations to the development, utilization, and evaluation of internal processes to ensure customer satisfaction, efficient operations, and accurate and timely resolution for all complaints and issues. 
  • Monitors workflow procedures and systems for an efficient and timely operation that is responsive to customers (members, discharge planners, VNSNY employees, physicians, families, etc.) and operational needs.  Troubleshoots difficult customer service issues, facilitates problem resolution and directs staff in addressing and resolving day-to-day operational issues.
  • Assists management team in the development of long- and short- range objectives for department, which includes system and operational rollouts and coordination of non clinical support functions to facilitate effective clinical operations.
  • Provides input to the Education and Quality department regarding training needs for new initiatives.  Participates in the overall planning, implementation and evaluation of such programs.   
  • Works with management to develop and implement strategies and actions to improve the quality of the team’s performance, which includes participation in workflow reengineering, process improvement, risk mitigation and computer application development activities.
  • Ensures adherence to regulatory and VNSNY CHOICE standards to ensure compliant operations and department’s readiness for internal and external audits.
  • Oversees business operations, workflows, utilization and schedules; contributes to systems design and implementation; and participates in developing standards to measure, maintain and maximize efficiencies and meet operational needs.
  • Performs all duties inherent in a  supervisory role.  Ensures effective staff training, interviews candidates for employment, evaluates staff performance, and recommends hiring, promotions, salary actions, and terminations as appropriate.
  • Participates in special projects and performs other duties as assigned.

CA2017


Qualifications
  • License and current registration to practice as a Registered Professional Nurse in New York State or Licensed Social Worker required.
  • Bachelor’s degree in Nursing or other health related degree required for RNs.  Master’s degree in Social Work required for LSW.
  • Minimum three years progressive customer service or business operations experience required, preferably in a health care environment. 
  • Proficient in Personal Computers applications, including Microsoft Word and Excel required. 
  • Knowledge of medical terminology, pharmacology information and /or insurance terminology required.
  •  Strong knowledge of operations of manual and automated office systems and procedures required. 
  • Strong operational skills with attention to detail required. 
  • Supervisory experience preferred.
  • Strong knowledge of third party payer requirement for reimbursement preferred.

ABOUT US

The Visiting Nurse Service of New York (VNSNY) is one of the nation's largest not-for-profit home- and community-based health care organizations, serving the five boroughs of New York City, and Nassau, Suffolk, and Westchester Counties. For over 125 years, VNSNY has been committed to improving the health and well-being of people through high-quality, cost-effective health care in the home and community. We offer a wide range of services, programs, and health plans to meet the diverse needs of our patients, health plan members, and clients from before birth to the end of life. On any given day, VNSNY employees - including nurses, rehabilitation therapists, social workers, home health aides and other professionals - deliver compassionate care, unparalleled medical expertise, and 24/7 solutions and resources to approximately 40,000 individuals in our care helping them to live the best lives possible in their homes and communities.