Supervisor Health Plan Operations - USFHP
$39.45 - $61.24 per hourPacMed Clinics
Description 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. Providence caregivers are not simply valued – they’re invaluable. Join our team at Pacmed Clinics DBA Pacific Medical Centers and thrive in our culture of patient-focused, whole-person care built on understanding, commitment, and mutual respect. Your voice matters here, because we know that to inspire and retain the best people, we must empower them. Required Qualifications 4 years health care referrals experience 2 years experience in a supervisory capacity, including Lead role, or 6 months supervisory experience within a healthplan Preferred Qualifications Bachelor's degree in Health Care Administration or Business Administration Why Join Providence? 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. Accepting a new position at another facility that is part of the Providence family of organizations may change your current benefits. Changes in benefits, including paid time-off, happen for various reasons. These reasons can include changes of Legal Employer, FTE, Union, location, time-off plan policies, availability of health and welfare benefit plan offerings, and other various reasons. About Providence At Providence, our strength lies in Our Promise of “Know me, care for me, ease my way.” Working at our family of organizations means that regardless of your role, we’ll walk alongside you in your career, supporting you so you can support others. We provide best-in-class benefits and we foster an inclusive workplace where diversity is valued, and everyone is essential, heard and respected. Together, our 120,000 caregivers (all employees) serve in over 50 hospitals, over 1,000 clinics and a full range of health and social services across Alaska, California, Montana, New Mexico, Oregon, Texas and Washington. As a comprehensive health care organization, we are serving more people, advancing best practices and continuing our more than 100-year tradition of serving the poor and vulnerable. About The Team Pacific Medical Centers (PacMed) is a private, not-for-profit, primary and integrated multi-specialty health care network with outpatient clinics and primary and specialty care providers in King, Snohomish and Pierce counties. We combine decades of patient-centered care with cutting-edge technology, first-class facilities and board-certified providers. Our strong team environment and respect for our people—at all levels and from all backgrounds—allow us to provide authentic care that achieves the highest-quality patient outcomes, backed by the strong network of resources and support through our affiliation with the Providence family, including local partners like Swedish Health Services. 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. Applicants in the Unincorporated County of Los Angeles: Qualified applications with arrest or conviction records will be considered for employment in accordance with the Unincorporated Los Angeles County Fair Chance Ordinance for Employers and the California Fair Chance Act. Pay range: $39.45 - $61.24. The amounts listed 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. Address: WA Renton 620 Naches Ave SW Work Location: Blackriver Corporate Park-Renton Workplace Type: On-site #J-18808-Ljbffr PacMed Clinics
- ...under the supervision of the Director of USFHP Operations. Responsibilities include ensuring... ...monthly reporting and yearly reviews by each plan to assure continued compliance with standards... .... Serves as a member of the US Family Health Plan management team. Jointly manages...OperationsHealth InsuranceMinimum wageContract workShift workNight shift
$39.45 - $61.24 per hour
Supervisor Health Plan Operations - USFHP Join to apply for the Supervisor Health Plan Operations - USFHP role at Pacific Medical Centers Description Organizes and directs the daily activities and department workflows of USFHP operational departments under the supervision...OperationsHealth InsuranceContract workLocal area- Providence is seeking a leader to organize and direct the day-to-day operations of the Referrals and Referral Support Staff at PacMed Clinics.... ...other government guidelines. The ideal candidate has extensive health care referrals experience and supervisory background, with a...OperationsHealth Insurance
- PacMed Clinics in Renton, WA, seeks a Referrals and Referral Support Supervisor to oversee daily activities of the referrals team under the USFHP Operations Director. You will ensure data entry accuracy, timely processing of authorizations and referrals, and compliance...OperationsHealth Insurance
- A healthcare organization in Seattle seeks a Supervisor for Health Plan Operations. This role involves directing workflows, ensuring compliance with guidelines, and training staff. Ideal candidates will have 4 years in health care claims and supervisory experience. Join...OperationsHealth Insurance
- ...and maintenance of the Network Plan the provider handbook, for... ...and spokesperson for US Family Health Plan both internally and externally... ...manner in accordance with USFHP contracting principles, organizational... ...:5 years of Managed care operations.Extensive experience and...OperationsHealth InsuranceMinimum wageContract workLocal areaShift work
$26.9 - $41.89 per hour
...results? As a Lead Claims Specialist supporting the US Family Health Plan (USFHP) at Pacific Medical Centers, you'll be the go-to authority... ...Business Administration 4 years experience in Managed Care operations, including a minimum of 3 years claims processing experience...OperationsHealth InsuranceMinimum wageFull timeLocal areaShift work$120k - $135k
As a Director, Health Plans, this professional will own the full account relationship, serving as both the account executive and the day-... ...expected to run their own accounts, build their own analyses, and operate independently in a fast-moving, startup-paced environment....OperationsHealth InsuranceContract workCasual workRemote workFlexible hours$146.4k - $235.38k
...cost optimization, risk mitigation, and operational excellence. You will combine deep procurement... ...Finance and Business Partners during planning cycles to provide spend forecasts,... ..., adoption or foster care placementFull Health Benefits Plans: options for 100% employer...OperationsHealth InsurancePermanent employmentFull timeContract workWork at officeLocal areaRemote work2 days per week$132.7k - $206.8k
...What you'll do The Customer Success Operations Manager - CS Experience is a strategic operations... ...from design through execution ensuring plans, dependencies, and risks are visible and... ..., adoption or foster care placementFull Health Benefits Plans: options for 100% employer...OperationsHealth InsurancePermanent employmentFull timeContract workWork at officeLocal areaRemote work2 days per week$132.7k - $206.8k
...management (CLM).What you'll doAs a CS Strategy & Operations Program Manager, you will be responsible... ...with senior leaders to proactively plan program objectives, scope, and... ...birth, adoption or foster care placementFull Health Benefits Plans: options for 100% employer...OperationsHealth InsurancePermanent employmentFull timeContract workWork at officeLocal areaRemote work2 days per week- ...team today. Dreamclinic is a leader in the health and wellness industry with an established... ...for our clients by managing the daily operations of the location, maintaining a clean and... ...performance) Company Sponsored Health Insurance Plan (Kaiser) Employee-paid Dental and Vision...OperationsHealth InsuranceImmediate start
$183.4k - $322.1k
...delivers service strategy engagements for Health Care clients. This role combines service... ...work across strategy, technology, and operations to ensure strategies become real, measurable... ..., dependency management, and execution planning to drive delivery with speed and...OperationsHealth InsuranceLocal areaVisa sponsorship$164.7k - $266k
...our GTM strategy and architecture, drive operational rigor and remove friction, and deliver the... ...roles are eligible for a company bonus plan, which is calculated as a percentage of eligible... ..., adoption or foster care placementFull Health Benefits Plans: options for 100% employer...OperationsHealth InsurancePermanent employmentFull timeContract workWork at officeLocal areaRemote work2 days per week$25.61 - $39.88 per hour
...department resource for at least one major area of expertise (EDI, Health Plan Repricing, Health Plus Repricing, or HPR). Providence... ...Health Care Business Administration. 4 years of Managed Care operations, including a minimum of 3 years claims processing experience,...OperationsHealth InsuranceMinimum wageLocal areaShift work$146.4k - $235.38k
...lifecycle management (CLM).What you'll doThe GTM CS Strategy & Operations Manager proactively plans and delivers critical business insights and articulates... ...after birth, adoption or foster care placementFull Health Benefits Plans: options for 100% employer paid and...OperationsHealth InsurancePermanent employmentFull timeContract workTemporary workWork at officeLocal areaRemote work2 days per week$160k - $200k
...SUMMARYThe Safety Manager - Health & Industrial Hygiene is responsible... ..., regional safety staff, operations leadership, and trade... ...including a choice of two benefit plans - a PPO plan and a High Deductible... ...team-building, and a strong supervisor/employee relationship. To...OperationsHealth InsuranceTemporary workFor subcontractorWork at officeImmediate start$175.18k - $220.56k
...that the care provided meets Neighborcare Health’s goals for quality, patient access and... ...access to health care in the area. The clinic operated in the back of the Motherlode Tavern with... ...performance issues, develop improvement plans and coordinate with Clinic Administrator...OperationsHealth InsuranceFull timeTraineeship$137.37k - $234.9k
...organization committed to improving community health through compassionate, equitable care.... ...communities.The Director of Financial Planning is a strategic leadership role... ...position partners closely with executive and operational leaders to drive sustainable growth, strengthen...OperationsHealth InsuranceContract workWork at officeLocal area$117.5k - $222.99k
...assigned payer products and offerings. This role translates health plan customer needs, market trends, and client insights into differentiated... ...improve product value, user experience, scalability, and operational efficiency. Serving as the payer product subject matter...OperationsHealth InsuranceFull timeTemporary workWork experience placementRemote workFlexible hours$70k
...the heart of delivering high-quality mental health care. Prescribers manage complex caseloads, and... ...currently supporting multiple offices, with plans to scale in coming years. Their primary focus will be to drive operational excellence, reduce administrative burden for...OperationsHealth InsuranceFull time$62.9 - $99.31 per hour
...with a wide range of stakeholders-including Nursing and Operations leaders, Educators, Quality and Safety leaders,... ...changes of Legal Employer, FTE, Union, location, time-off plan policies, availability of health and welfare benefit plan offerings, and other various reasons...OperationsHealth InsuranceMinimum wageLocal areaShift work- ...assistance Well-being on demand Perks at Work Competitive health and welfare plans-HSA company contribution 401(k) company match Great culture... .... Works in conjunction with the Regional Sales Manager, operations, reimbursement team, and related departments. Primary objective...OperationsHealth InsuranceTemporary workLocal areaRemote work
$140k - $170k
...Director Clinical Operations Location: Renton, WA Position: Hospice Director of Clinical Operations Registered Nurse Salary: $1... ...Schedule: M-F / Limited On call support as needed Competitive Health Benefits Generous PTO, Matching 401k Mileage...OperationsHealth InsuranceWork experience placementLocal areaFlexible hours$225k - $267.4k
Community Health of Central WA (CHCW) is an organization focused on patient centered care... ...and executes the organizational strategic plan, growth and expansion of services,... ...with the clinic manager regarding general operations of the clinic Supervises providers Maintains...OperationsHealth InsuranceFull timeRelocation packageFlexible hours- Mission Pet Health is seeking a Regional Medical Director (RMD) to support our hospitals... ...while working alongside a Regional Operations Director to align medical leadership with... ...through mentorship, coaching, and development planning. Conduct doctor reviews and help...OperationsHealth InsuranceTemporary workInternshipLive inLocal areaWork from homeHome office3 days per week
$164.7k - $266k
...you'll doThe Director, Growth Strategy & Operations serves as a trusted operational leader... ...Operations, helping drive the operating cadence, planning processes, and cross-functional... ..., adoption or foster care placementFull Health Benefits Plans: options for 100% employer...OperationsHealth InsurancePermanent employmentFull timeContract workWork at officeLocal areaRemote work2 days per week- ...clients exceed their financial health goals. Across the... ...PT, as the current business operations are aligned to the Pacific Time... ...requirements may be assigned by supervisors as deemed appropriate. About... ...Health partners with health plans across the country to drive clinical...OperationsHealth InsuranceRemote jobFull timeWork at officeLocal areaMonday to FridayShift work
- ...most prestigious healthcare facilities including: Fortune 100 Health Plans, Mail Order Pharmacies, Medical Billing Centers, Hospitals,... ...Description Position Purpose: Perform duties related to the day-to-day operations of the Service Management functions for Foster Care members...OperationsHealth InsuranceFull timePrivate practiceShift work
- ...Clinical Director: build and lead our new Home Health agency from day one. ⭐ Your Mission... ...: referral acceptance → SOC assessment → Plan of Care → skilled visits → documentation... ...Implement dashboards, KPIs, and scalable operational processes Develop productivity,...OperationsHealth InsuranceWork at officeImmediate start
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