Health Services Clinical Supervisor

• Provide education and training to health services clinical and administrative staff
• Serve as a resource for other CenCal Health staff
• Identify areas for process improvements and assists with their implementation
• Support administrative and clinical staff in answering phone inquiries
• As assigned, perform retrospective claims review
• Carry a daily caseload of utilization or case management activities as assigned; supports clinical staff with day-to-day activities related to the review, coordination, care planning, and transition of care
• Interface with and serve as a resource to members and providers to clarify processes, answer questions, and address issues or concerns
• Handle and resolve daily issues, concerns and disputes of unit staff
• Provide new staff orientation and mentor activities
• Assist and coordinate staff assignments and coverages
• Identify problems or issues within established utilization management (UM) or case management (CM) processes, policies or procedures, and make suggestions for efficient resolution
• Identify process-oriented opportunities for improvement
• Assist with coordination and facilitation of regular staff meetings
• Participate in internal and external audits
• Supervise staff
• Other duties as assigned

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