Supervisor Quality Of Care/Immediate Advocacy

Supervisor of Quality of Care/Immediate Advocacy (Remote)

• Are you motivated, energetic, and excited to become part of the Acentra Health team?
• Do you value care management and quality improvement?
• Are you an experienced Supervisor of Quality of Care/Immediate Advocacy looking for a new challenge?

If so, you might be our next new team member!

Who we need:

This position supervises and reviews operations day-to-day activities of the nurse reviewers in the assigned areas to successfully meet contract deliverables. Assists in meeting contract deliverables related to the Review Department within budgetary parameters.

Why us?

Acentra Health is a rapidly growing national quality improvement and care management organization. We work to ensure that over 20 million people receive the right care, at the right time, in the right setting.

People Focused. Mission Driven.

Shape the future of healthcare with us. We are mission driven to improve lives through healthcare quality and clinical expertise.

We do this through our people.

At Acentra Health, you can do meaningful work that makes a real difference for the lives of individuals across the country. We are an organization that cares deeply about our employees and we provide the training and support to do the best work of your career.

Benefits are a key component of your rewards package at Acentra Health. These benefits are designed to provide you and your family additional protection, security, and support for both your career and your life away from work. They are comprehensive and fit a variety of needs and situations. Our benefits include comprehensive health plans, paid time off, retirement savings, corporate wellness, educational assistance, corporate discounts and more.

What you’ll do:

• Identify Clinical Reviewers’ orientation and continuous learning needs and in collaboration with the Manager, Operations, develops and implements plans to address those identified learning needs.
• Maintains current knowledge base related to review processes and clinical practices related to the review processes; functions as the initial resource to clinical reviewers regarding all review process questions and/or concerns.
• Assesses, evaluates and addresses daily work load and queues; adjusts work schedules daily to meet the workload demands of the department.
• Analyzes productivity of clinical reviewers.
• Functions as providers’ liaison and contact/resource person for provider customer service issues and problem resolution.
• Responsible for the quality monitoring activities including identifying areas of improvement and plan implementation of improvement areas.
• Performs all applicable review types as workload indicates.
• Assures accuracy and timeliness of all applicable review type cases within contract requirements.

The list of accountabilities is not intended to be all-inclusive and may be expanded to include other duties that management may deem necessary from time to time.

What you’ll need:

Required Qualifications

• ASN or equivalent nursing education required. BSN preferred.
• Active RN licensure required.
• Graduation from accredited Baccalaureate Social Work program – MSW preferred

Knowledge, Skills, Abilities

• Organizational skills, ability to plan and prioritize multiple assignments essential.
• Knowledge of current NCQA/URAC/CMS standards preferred.
• Excellent interpersonal skills required.
• Experience with Quality Improvement/Quality Assurance.
• Excellent verbal and written communication skills essential.
• Computer proficiency in Microsoft Office and other software programs operating in a Windows environment.

Experience

• Two years recent clinical experience.
• Previous workload management experience strongly preferred.
• Minimum of three (3) years supervisory experience in a health-care field with a minimum of 1-3 years review experience required.

Thank You!

We know your time is valuable and we thank you in advance for applying for this position. Due to the high volume of applicants we receive, only those who are chosen to advance in our interview process will be contacted. We sincerely appreciate your interest in Acentra Health and invite you to apply to future openings that may be of interest. Best of luck in your search!

~ The Acentra Health Talent Acquisition Team

Mental And Physical Requirements

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations will be made as required by law in an attempt to enable an individual with a disability to perform the essential functions of this job. While performing the duties of this job, the employee is regularly required to sit for prolonged periods of time; key and/or control objects; interact extensively with internal and external customers; occasionally lift and/or move objects weighing up to 10 pounds; and occasionally travel within the state.

EOE AA M/F/Vet/Disability

Acentra Health is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.