Supervisor, Program Coordination

Centene Corporation Pittsburgh , PA 15201

Posted 2 months ago

Position Purpose: Perform collaborative duties for the development and implementation of all Coordinated Care programs (OB/NICU, Asthma, Diabetes, ER, General/Catastrophic); Provide support and supervision to ensure quality and continuity of services delivered to Members, Providers and staff.

Develop and oversee aspects of coordinated care program activities

Develop and implement management software and reporting mechanisms for specific outcome measurement and data reporting

Identify referrals for coordinated care programs.

Develop plan specific literature and educational components for member and provider distribution.

Oversee contract negotiation and execution components for Prenatal Coordinated Care (PNCC) entities

Collaborate with various departments to extract data for identification of program members and to report program outcomes

Identify processes and work flow improvements to foster efficient and effective case management efforts

Monitor distribution of members identified for case management to ensure positive results and program success

Education/Experience: High school diploma or equivalent. 5 years of prior authorization, physician's office, customer service, claims processing or provider relations experience preferably in a managed care setting. Previous experience as a lead in a functional area or managing cross functional teams on large scale projects.

Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.


icon no score

See how you match
to the job

Find your dream job anywhere
with the LiveCareer app.
Mobile App Icon
Download the
LiveCareer app and find
your dream job anywhere
App Store Icon Google Play Icon
lc_ad

Boost your job search productivity with our
free Chrome Extension!

lc_apply_tool GET EXTENSION

Similar Jobs

Want to see jobs matched to your resume? Upload One Now! Remove
Adult IDD Day Center Program Specialist Supervisor In Monroeville

The Mentor Network

Posted 2 days ago

VIEW JOBS 5/29/2020 12:00:00 AM 2020-08-27T00:00 Description Adult IDD Day Center Program Specialist - Supervisor in Monroeville Primary Location: United States-PA-PAPittsburgh Function:Program Services Coordination/Case Management The health and safety of our employees and of those individuals we serve is of utmost importance to us. To be sure we extend that concern to our recruitment process, we will be leveraging digital capabilities to meet virtually and continue to recruit top talent at Pennsylvania MENTOR, a partner of The MENTOR Network. Due to the public health concerns regarding COVID-19, as your application progresses, you will be asked to participate in virtual interviews using one of our digital tools. Our recruitment team will provide further details to assist you in your recruitment journey. Thank you for your flexibility and understanding as we focus on the safety and well-being of those we serve, as well as one another. Description Every person needs the support of others, but we look for very special people to support individuals with disabilities, behavioral or medical complexities. As a Program Specialist with Pennsylvania Mentor you'll be one of those special people. For The MENTOR Network, a Program Specialist is critical to our success and exemplifies the wonderful mission driven work we do here every day. This role is a fantastic way to continue your career path in Social and Human Services with a myriad of career options to move up and across the organization. Pennsylvania Mentor is seeking a Program Specialist/Program Supervisor to observe individuals, review data and progress, and revise programs based on individual need and performance. This individual will ensure consistency among external and internal programs, and disciplines to ensure delivery; providing each individual with an appropriate active treatment program. The Program Specialist ensures that any discrepancies or conflicts between programmatic, medical, dietary, and vocational aspects of the individual's assessment and program are resolved. The role also ensures follow-up to recommendations for services, equipment, or programs and that those adequate supports and assistive devices are present to promote independence. The Program Specialist will also be responsible to ensure staff schedules are maintained to meet service plans to properly assist and support in social, behavioral, and health care needs in all areas of the program. The PS acts as a "go to" person for that program, serving as a mentor to other employees, promoting teamwork, and identifying any training needs. In addition to coordinating the activities of the employees within that program, the Program Specialist delivers direct care services to individuals on an ongoing basis. Responsibilities/Duties: * Under the supervision of the Program Director, oversee the day-to-day operation of the program * Lead services within a designated service or program * Provide coaching and mentoring to staff * Supervise daily activities of staff * Coordinate the activities for, and maintain schedules of, the employees of the program * Provide direct care and support to assigned individuals * Provide input and feedback in hiring, disciplinary, and firing decisions * Responsible for ensuring that onboarding, orientation and ongoing training is delivered Qualifications: Requirements: * Bachelor's Degree in human service related field and one year experience in direct service with people with developmental disabilities (IDD) required - OR- a combination of 60+ college credits and 4+ years of direct IDD service as required by the State of Pennsylvania. * Prior experience with Day Programs. * Supervisory Experience * Excellent computer skills * Other education and experience plus licensing as required by state Founded in 1980, The MENTOR Network is a national network of local human services providers offering an array of quality, community-based services in more than 30 states to adults with intellectual and developmental disabilities, brain and spinal cord injuries and other catastrophic injuries and illnesses, and to youth with emotional, behavioral and medically complex challenges as well as their families. EOE/AAE Requirements: * Bachelor's Degree in human service related field and one year experience in direct service with people with developmental disabilities (IDD) required - OR- a combination of 60+ college credits and 4+ years of direct IDD service as required by the State of Pennsylvania. * Prior experience with Day Programs. * Supervisory Experience * Excellent computer skills * Other education and experience plus licensing as required by state Founded in 1980, The MENTOR Network is a national network of local human services providers offering an array of quality, community-based services in more than 30 states to adults with intellectual and developmental disabilities, brain and spinal cord injuries and other catastrophic injuries and illnesses, and to youth with emotional, behavioral and medically complex challenges as well as their families. EOE/AAE The Mentor Network Pittsburgh PA

Supervisor, Program Coordination

Centene Corporation