Referral Operations Supervisor - Health Plan Compliance

Responsibilities Organizes and directs the daily activities and department workflow of the Referrals and Referral Support Staff under the supervision of the Director of USFHP Operations. Responsibilities include ensuring accurate and timely data entry and processing of authorization and referrals of Pacific Medical Centers' revenues and expenses for outside e (OPS). Assures compliance with DoD and other government agency guidelines and contract requirements. Sets Referral policy and monitors compliance to same. Monitors Medicare and TRICARE referral guidelines and educates staff in changes. Identifies and solves processing issues with outside providers. Serves as a member of the US Family Health Plan management team. Jointly manages the US Family Health Plan budget with the Director of USFHP Operations and the other members of the management team. Required Qualifications 4 years health care referrals experience. 2 years supervisory capacity, including Lead role; or six months supervisory experience within Pacific Medical Centers. Preferred Qualifications Bachelor's Degree in Health Care Administration or Business Administration. Benefits Our best-in-class benefits are uniquely designed to support you and your family in staying well, growing professionally and achieving financial security. We take care of you, so you can focus on delivering our mission to advocate, educate and provide extraordinary care. Pay Range Posted are the minimum and the maximum wage rates on the wage range for this position. The successful candidate's placement on the wage range for this position will be determined based upon relevant job experience and other applicable factors. These amounts are the base pay range; additional compensation may be available for this role, such as shift differentials, standby/on-call, overtime, premiums, extra shift incentives, or bonus opportunities. EEO Statement Providence is proud to be an Equal Opportunity Employer. We are committed to the principle that every workforce member has the right to work in surroundings that are free from all forms of unlawful discrimination and harassment on the basis of race, color, gender, disability, veteran, military status, religion, age, creed, national origin, sexual identity or expression, sexual orientation, marital status, genetic information, or any other basis prohibited by local, state, or federal law. We believe diversity makes us stronger, so we are dedicated to shaping an inclusive workforce, learning from each other, and creating equal opportunities for advancement. #J-18808-Ljbffr Pacific Medical Centers Corp