Supervisor Care Management

Job Title: Supervisor Care Management (Model of Care)

Department: HS-Population Health

About the Role:

The Supervisor Care Management (Model of Care) position is responsible for the direct daily supervision of care management activities of case managers and care coordinators for assigned Model of Care populations. This role ensures high-quality cost-effective and patient-centered care through effective supervision of care management operations clinical staff and interdisciplinary care coordination. The Supervisor will serve as a key leader in maintaining compliance with health plan requirements regulatory guidelines and internal quality standards. This role reports to the Manager Care Management.

What Youll Do

Leadership & Oversight

• Provide daily supervision of care management teams ensuring adherence to ambulatory care management model of care policies procedures and regulatory requirements.
• Oversee clinical care management services across the continuum supporting staff performance and clinical quality.
• Ensure consistent application of policies and implement corrective or disciplinary actions when needed.
• Other projects and duties as assigned by the Clinical Leadership team.

Program & Compliance Management

• Monitor and support implementation of the Astrana Health care management process including training and documentation.
• Review health plan reports to identify members needing care coordination or targeted interventions.
• Ensure all care management activities comply with NCQA standards CMS health plan and state regulations and internal protocols.

Clinical Oversight & Coordination

• Support development and review of individualised care plans and integrate care strategies across disciplines.
• Lead or participate in Multi-Disciplinary Care Team (MDT) meetings providing operational insight and solutions for complex cases.
• Engage with network PCPs specialists and vendors to ensure timely appropriate care coordination and service use.
• Collaborate with Utilisation Management Inpatient Case Management and Ambulatory Care to ensure continuity across care transitions.
• Monitor and evaluate case management plans modifying as needed to meet regulatory requirements coordinate services evaluate treatments intervene in crises and provide support.

Quality Utilization & Financial Strategy

• Conduct internal audits of ambulatory care management cases and provide feedback and coaching to staff.
• Educate and support staff on documentation standards best practices and quality improvement opportunities.
• Assist with submission deliverables for health plan audits.

Administrative & Staff Development

• Conduct performance evaluations of care management staff including audits of care plans assessments and documentation.
• Monitor staff attendance and ensure accountability to organisational expectations.
• Provide mentorship and training to foster excellence collaboration and continuous improvement.
• Oversee hiring onboarding and training of new staff.
• Maintain staff timekeeping and personnel records.
• Other duties as assigned.

Qualifications

• Active RN or LVN unrestricted license required
• Minimum of 3 years of care management experience in a medical group IPA or HMO setting
• Associate Degree of Science in Nursing

Youre great for the role if:

• Bachelors degree in healthcare related fields
• Knowledge of NCQA standards Model of Care and Case Management requirements CMS and state regulations and HMO/ACO model structures
• Strong communication leadership and critical thinking skills
• Proven ability to work cross-functionally with clinicians leadership and administrative staff to drive outcomes
• Experience in managing diverse teams and leading quality-focused initiatives
• Skilled with the use of the Microsoft Office suite of products and the ability to use and effectively learn and navigate other computer systems

Environmental Job Requirements and Working Conditions

• Our organization follows a hybrid work structure where the expectation is to work both in office and at home on a weekly basis. The office is located at 1600 Corporate Center Dr. Monterey Park CA 91754.
• The annual total compensation target pay range for this role is: $85000 - $98000. Actual compensation will be determined based on geographic location (current or future) experience and other job-related factors.

Astrana Health is proud to be an Equal Employment Opportunity and Affirmative Action employer. We do not discriminate based upon race religion color national origin gender (including pregnancy childbirth or related medical conditions) sexual orientation gender identity gender expression age status as a protected veteran status as an individual with a disability or other applicable legally protected characteristics. All employment is decided on the basis of qualifications merit and business need. If you require assistance in applying for open positions due to a disability please email us at to request an accommodation.

Additional Information:

The job description does not constitute an employment agreement between the employer and employee and is subject to change by the employer as the needs of the employer and requirements of the job change.

Required Experience:

Manager