Managing Supervisor jobs at Centene - 237 jobs

You could be the one who changes everything for our 28 million members as a Customer Care professional at Centene. As a diversified, national organization, you'll have access to competitive benefits including a fresh perspective on workplace flexibility. Must be authorized to work in the U.S. without the need for employment-based visa sponsorship now or in the future. Sponsorship and future sponsorship are not available for this opportunity, including employment-based visa types H-1B, L-1, O-1, H-1B1, F-1, J-1, OPT, or CPT. This position is primarily remote. However, location near Tampa Bay, Florida is preferred to be able to come into the office as needed. Position Purpose: Oversees and offers guidance around current contact center operational processes to establish operational targets, best practices, and training programs that support service, quality, and efficiency standards. Supports contact center staff with day-to-day oversight and resources for contact center operations. Oversees daily operations of contact center teams by planning, directing, and evaluating team performance to ensure customer satisfaction, compliance, and standards Monitors interactions, workflow, and metrics of the contact center to ensure adherence to performance, quality, and efficiency standards Serves as primary point of contact for contact center and operations employees and resolves complex issues Manages and maintains policies, procedures, and regulations to ensure compliance requirements are achieved Provides training and coaching to direct reports for operational improvement within the contact center Evaluates contact center operations team on performance and provides feedback on improvement opportunity and career growth path Collaborates with training teams to develop, review, and approve of appropriate training materials and/or programs for contact center operations team members Supports contact center operations senior management with onboarding, hiring, and training new employees, recent promotes, and transfers to department Performs other duties as assigned Complies with all policies and standards Education/Experience: Requires a Bachelor's degree and 4+ years of related experience. Or equivalent experience acquired through accomplishments of applicable knowledge, duties, scope and skill reflective of the level of this position.Pay Range: $56,200.00 - $101,000.00 per year Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law, including full-time or part-time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility. 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. Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act

Supervises and coordinates the day-to-day business operations of clinical and non clinical support activities, including monitoring internal processes, coordinating activities between the clinical and non-clinical staff, and supervising support functions to facilitate efficient clinical operations. Makes recommendations on operational improvements for the department. Works under general supervision. What We Provide: Referral bonus opportunities Generous paid time off (PTO), starting at 30 days of paid time off and 9 company holidays Health insurance plan for you and your loved ones, Medical, Dental, Vision, Life Disability Employer-matched retirement saving funds Personal and financial wellness programs Pre-tax flexible spending accounts (FSAs) for healthcare and dependent care Generous tuition reimbursement for qualifying degrees Opportunities for professional growth and career advancement Internal mobility, generous tuition reimbursement, CEU credits, and advancement opportunities What You Will Do: Supervises the day-to-day operations of VNS Health Plans Medical Management clinical and non clinical staff. Makes recommendations to the development, utilization, and evaluation of internal processes to ensure customer satisfaction, efficient operations, and accurate and timely resolution for all complaints and issues. Monitors workflow procedures and systems for an efficient and timely operation that is responsive to customers (members, discharge planners, VNS Health employees, physicians, families, etc.) and operational needs. Troubleshoots difficult customer service issues, facilitates problem resolution and directs staff in addressing and resolving day-to-day operational issues. Assists management team in the development of long- and short- range objectives for department, which includes system and operational rollouts and coordination of non clinical support functions to facilitate effective clinical operations. Provides input to the Education and and Quality department regarding training needs for new initiatives. Participates in the overall planning, implementation and evaluation of such programs. Works with management to develop and implement strategies and actions to improve the quality of the team's performance, which includes participation in workflow reengineering, process improvement, risk mitigation and computer application development activities. Ensures adherence to regulatory and VNS Health Plans standards to ensure compliant operations and department's readiness for internal and external audits. Oversees business operations, workflows, utilization and schedules; contributes to systems design and implementation; and participates in developing standards to measure, maintain and maximize efficiencies and meet operational needs. Performs all duties inherent in a supervisory role. Ensures effective staff training, interviews candidates for employment, evaluates staff performance, and recommends hiring, promotions, salary actions, and terminations as appropriate. Participates in special projects and performs other duties as assigned. Qualifications Licenses and Certifications: License and current registration to practice as a Registered Professional Nurse in New York State required Education: Bachelor's Degree in Nursing or other health related degree for RNs required Work Experience: Minimum three years progressive customer service or business operations experience, preferably in a health care environment. Required Supervisory experience Preferred Proficient in Personal Computers applications, including Microsoft Word and Excel Required Knowledge of medical terminology, pharmacology information and /or insurance terminology Required Strong knowledge of operations of manual and automated office systems and procedures Required Strong knowledge of third party payer requirement for reimbursement Preferred Strong operational skills with attention to detail Required Pay Range USD $93,400.00 - USD $116,800.00 /Yr. About Us VNS Health is one of the nation's largest nonprofit home and community-based health care organizations. Innovating in health care for more than 130 years, our commitment to health and well-being is what drives us - we help people live, age and heal where they feel most comfortable, in their own homes, connected to their family and community. On any given day, more than 10,000 VNS Health team members deliver compassionate care, unparalleled expertise and 24/7 solutions and resources to the more than 43,000 “neighbors” who look to us for care. Powered and informed by data analytics that are unmatched in the home and community-health industry, VNS Health offers a full range of health care services, solutions and health plans designed to simplify the health care experience and meet the diverse and complex needs of the communities and people we serve in New York and beyond.

A leading health organization is seeking a remote employee to provide consultative support in claims adjudication. This full-time position involves defining business requirements and resolving complex issues in the health insurance domain. Candidates should have at least 2 years of experience, a High School Diploma, and proficiency in MS Excel. The salary ranges from $71,200 - $127,200 annually, with comprehensive benefits included. #J-18808-Ljbffr

Qualifications: To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. Reasonable accommodations may be made to enable qualified individuals with disabilities to perform the essential functions. Required: Able to demonstrate an expert level of knowledge with all assigned products, insurance coverages, services, policies, pricing, placement of coverage, regulations and benefits of each as well as the B&B philosophy regarding these products and services. Expertise in the insurance industry with a demonstrated ability to explain B&B capabilities relative to our competitors. Strong oral and written communication skills including the ability to connect with an audience and speak persuasively and succinctly. Demonstrates good listening skills to enhance understanding and probes effectively. Strong attention to detail. Strong time management skills and the ability to evaluate and prioritize multiple projects/tasks to maximize the number of internal and external clients that can be assisted while maintaining a high level of customer service. Demonstrates a sense of urgency. Works in a collaborative, team-oriented manner, fostering empowerment and ownership for service quality. Develops and maintains a working knowledge of B&B systems. Good keyboard and PC skills using word processing and spreadsheet software, familiarity with various software applications and the ability to learn new software systems. Ability to work in a team environment that is constantly changing. College degree preferred. 5 or more years of experience in the industry and licensed in applicable state if needed. Participates in continuing education in order to maintain the appropriate level of credentials. Insurance designation preferred. This position may require routine or periodic travel which may require the teammate to drive their own vehicle or a rental vehicle. If required, acceptable results of a Motor Vehicle Record report at the time of hire and periodically thereafter, and maintenance of minimum acceptable insurance coverages are requirements of this position.

To provide daily supervision of utilization management staff. Provide departmental leadership, support, resources and direction to staff. Assists in developing and maintaining a cohesive team with a high level of productivity, accuracy and quality to achieve departmental goals and objectives. Responsibilities Provides daily leadership, direction, resources, training, evaluation, coverage and program support to assigned staff. Performs supervisory functions such as timecard management, staff scheduling to meet business requirements and directing work activities. Provides performance feedback to utilization management staff and conducting annual reviews. Participates in the interviewing, hiring and on-boarding processes of new staff. Maintains active participation with inbound and outbound provider reporting and other related duties, adjusting assignments as necessary to meet business needs and/or regulations. Documents and maintains patient-specific records in the Partnership computer system, in databases and files as applicable. Participates in committees, workgroups and/or multidisciplinary teams to support Partnership's strategic plan, organizational goals, and/or business needs. Facilitates meetings with Partnership community provider partners as a part of utilization management process. Develops and maintains positive working relationships with all business partners to ensure optimum member care and provider satisfaction. Reviews department desktops, policies and procedures, recommends changes for more efficient operations, and communicates changes and updates to staff when appropriate. Researches and responds to provider issues or barriers ensuring successful outcomes and superb customer service. Audits medical records as appropriate for accuracy, workflow evaluation, staff feedback and process improvement activities. This position, in addition to his or her own case load, may be assigned cases in the area of oversight as deemed necessary to provide coverage. Evaluates appropriateness of care through interpretation of benefits as outlined in Title 22, Medi-Cal Provider Manual, DMHC CMS regulatory requirements, Partnership Policies and Procedures, and medical necessity criteria for each product line. Researches and responds to provider issues or barriers, ensuring successful outcomes and superb customer service. Participates in special projects and assignments as required. Qualifications Education and Experience Associate or Bachelor's degree in nursing. RN with 3-5 years' experience to include staff supervision; one (1) year managed care (case management) experience; or equivalent combination of education and experience. General knowledge of managed care with emphasis in case management preferred. Special Skills, Licenses and Certifications Current California RN license. RN Supervisor will be supervising both RN and LVN staff. Case Management certification preferred. Strong knowledge of nursing requirements in a clinical setting. Knowledge of utilization management programs as related to use of pre-set criteria and protocols. Familiarity with business practices and protocols with ability to access data and information using automated systems. Ability to work within an interdisciplinary structure and function independently in a fast-paced environment while managing multiple priorities and meeting deadlines. Strong organizational skills required. Effective telephone and computer data entry skills required. Valid California Driver's License and proof of current automobile insurance compliant with Partnership's policies are required to operate a vehicle and travel for company business. Performance Based Competencies Desired competencies (ex: Knowledge of DHCS, Medi-Cal, CMS, medically necessary criteria, CalAIM and/or NCQA regulations. Ability to work within an interdisciplinary structure and function independently in a fast-paced environment while managing multiple priorities and deadlines. Strong organizational skills required. Computer literacy and proficiency. Excellent written and verbal communication skills in English. Demonstrated experience and ability to build effective working relationships and to represent the department effectively in order to accomplish goals. Ability to manage multiple concurrent projects and maintain a work pace appropriate to the workload. Ability to assist individuals in recognizing and solving problems. Ability to supervise, train, motivate, provide guidance to staff. Work Environment And Physical Demands Ability to use a computer keyboard. Ability to prioritize workload and initiate action to acquire needed information from professionals by phone. Ability to function effectively with frequent interruptions and direction from multiple team members. More than 50% of work time is spent in front of a computer monitor. Must be able to lift, move, or carry objects of varying size, weighing up to 10 lbs. Some travel required (up to 25%) including occasional overnight. All HealthPlan employees are expected to: Provide the highest possible level of service to clients; Promote teamwork and cooperative effort among employees; Maintain safe practices; and Abide by the HealthPlan's policies and procedures, as they may from time to time be updated. HIRING RANGE: $136,296.78 - $177,185.82 IMPORTANT DISCLAIMER NOTICE The job duties, elements, responsibilities, skills, functions, experience, educational factors and the requirements and conditions listed in this are representative only and not exhaustive or definitive of the tasks that an employee may be required to perform. The employer reserves the right to revise this job description at any time and to require employees to perform other tasks as circumstances or conditions of its business, competitive considerations, or work environment change.

To provide daily supervision of utilization management staff. Provide departmental leadership, support, resources and direction to staff. Assists in developing and maintaining a cohesive team with a high level of productivity, accuracy and quality to achieve departmental goals and objectives. Responsibilities Provides daily leadership, direction, resources, training, evaluation, coverage and program support to assigned staff. Performs supervisory functions such as timecard management, staff scheduling to meet business requirements and directing work activities. Provides performance feedback to utilization management staff and conducting annual reviews. Participates in the interviewing, hiring and on-boarding processes of new staff. Maintains active participation with inbound and outbound provider reporting and other related duties, adjusting assignments as necessary to meet business needs and/or regulations. Documents and maintains patient-specific records in the Partnership computer system, in databases and files as applicable. Participates in committees, workgroups and/or multidisciplinary teams to support Partnership's strategic plan, organizational goals, and/or business needs. Facilitates meetings with Partnership community provider partners as a part of utilization management process. Develops and maintains positive working relationships with all business partners to ensure optimum member care and provider satisfaction. Reviews department desktops, policies and procedures, recommends changes for more efficient operations, and communicates changes and updates to staff when appropriate. Researches and responds to provider issues or barriers ensuring successful outcomes and superb customer service. Audits medical records as appropriate for accuracy, workflow evaluation, staff feedback and process improvement activities. This position, in addition to his or her own case load, may be assigned cases in the area of oversight as deemed necessary to provide coverage. Evaluates appropriateness of care through interpretation of benefits as outlined in Title 22, Medi-Cal Provider Manual, DMHC CMS regulatory requirements, Partnership Policies and Procedures, and medical necessity criteria for each product line. Researches and responds to provider issues or barriers, ensuring successful outcomes and superb customer service. Participates in special projects and assignments as required. Qualifications Education and Experience Associate or Bachelor's degree in nursing. RN with 3-5 years' experience to include staff supervision; one (1) year managed care (case management) experience; or equivalent combination of education and experience. General knowledge of managed care with emphasis in case management preferred. Special Skills, Licenses and Certifications Current California RN license. RN Supervisor will be supervising both RN and LVN staff. Case Management certification preferred. Strong knowledge of nursing requirements in a clinical setting. Knowledge of utilization management programs as related to use of pre-set criteria and protocols. Familiarity with business practices and protocols with ability to access data and information using automated systems. Ability to work within an interdisciplinary structure and function independently in a fast-paced environment while managing multiple priorities and meeting deadlines. Strong organizational skills required. Effective telephone and computer data entry skills required. Valid California Driver's License and proof of current automobile insurance compliant with Partnership's policies are required to operate a vehicle and travel for company business. Performance Based Competencies Desired competencies (ex: Knowledge of DHCS, Medi-Cal, CMS, medically necessary criteria, CalAIM and/or NCQA regulations. Ability to work within an interdisciplinary structure and function independently in a fast-paced environment while managing multiple priorities and deadlines. Strong organizational skills required. Computer literacy and proficiency. Excellent written and verbal communication skills in English. Demonstrated experience and ability to build effective working relationships and to represent the department effectively in order to accomplish goals. Ability to manage multiple concurrent projects and maintain a work pace appropriate to the workload. Ability to assist individuals in recognizing and solving problems. Ability to supervise, train, motivate, provide guidance to staff. Work Environment And Physical Demands Ability to use a computer keyboard. Ability to prioritize workload and initiate action to acquire needed information from professionals by phone. Ability to function effectively with frequent interruptions and direction from multiple team members. More than 50% of work time is spent in front of a computer monitor. Must be able to lift, move, or carry objects of varying size, weighing up to 10 lbs. Some travel required (up to 25%) including occasional overnight. All HealthPlan employees are expected to: Provide the highest possible level of service to clients; Promote teamwork and cooperative effort among employees; Maintain safe practices; and Abide by the HealthPlan's policies and procedures, as they may from time to time be updated. HIRING RANGE: $136,296.78 - $177,185.82 IMPORTANT DISCLAIMER NOTICE The job duties, elements, responsibilities, skills, functions, experience, educational factors and the requirements and conditions listed in this are representative only and not exhaustive or definitive of the tasks that an employee may be required to perform. The employer reserves the right to revise this job description at any time and to require employees to perform other tasks as circumstances or conditions of its business, competitive considerations, or work environment change.

To provide daily supervision of utilization management staff. Provide departmental leadership, support, resources and direction to staff. Assists in developing and maintaining a cohesive team with a high level of productivity, accuracy and quality to achieve departmental goals and objectives. Responsibilities Provides daily leadership, direction, resources, training, evaluation, coverage and program support to assigned staff. Performs supervisory functions such as timecard management, staff scheduling to meet business requirements and directing work activities. Provides performance feedback to utilization management staff and conducting annual reviews. Participates in the interviewing, hiring and on-boarding processes of new staff. Maintains active participation with inbound and outbound provider reporting and other related duties, adjusting assignments as necessary to meet business needs and/or regulations. Documents and maintains patient-specific records in the Partnership computer system, in databases and files as applicable. Participates in committees, workgroups and/or multidisciplinary teams to support Partnership's strategic plan, organizational goals, and/or business needs. Facilitates meetings with Partnership community provider partners as a part of utilization management process. Develops and maintains positive working relationships with all business partners to ensure optimum member care and provider satisfaction. Reviews department desktops, policies and procedures, recommends changes for more efficient operations, and communicates changes and updates to staff when appropriate. Researches and responds to provider issues or barriers ensuring successful outcomes and superb customer service. Audits medical records as appropriate for accuracy, workflow evaluation, staff feedback and process improvement activities. This position, in addition to his or her own case load, may be assigned cases in the area of oversight as deemed necessary to provide coverage. Evaluates appropriateness of care through interpretation of benefits as outlined in Title 22, Medi-Cal Provider Manual, DMHC CMS regulatory requirements, Partnership Policies and Procedures, and medical necessity criteria for each product line. Researches and responds to provider issues or barriers, ensuring successful outcomes and superb customer service. Participates in special projects and assignments as required. Qualifications Education and Experience Associate or Bachelor's degree in nursing. RN with 3-5 years' experience to include staff supervision; one (1) year managed care (case management) experience; or equivalent combination of education and experience. General knowledge of managed care with emphasis in case management preferred. Special Skills, Licenses and Certifications Current California RN license. RN Supervisor will be supervising both RN and LVN staff. Case Management certification preferred. Strong knowledge of nursing requirements in a clinical setting. Knowledge of utilization management programs as related to use of pre-set criteria and protocols. Familiarity with business practices and protocols with ability to access data and information using automated systems. Ability to work within an interdisciplinary structure and function independently in a fast-paced environment while managing multiple priorities and meeting deadlines. Strong organizational skills required. Effective telephone and computer data entry skills required. Valid California Driver's License and proof of current automobile insurance compliant with Partnership's policies are required to operate a vehicle and travel for company business. Performance Based Competencies Desired competencies (ex: Knowledge of DHCS, Medi-Cal, CMS, medically necessary criteria, CalAIM and/or NCQA regulations. Ability to work within an interdisciplinary structure and function independently in a fast-paced environment while managing multiple priorities and deadlines. Strong organizational skills required. Computer literacy and proficiency. Excellent written and verbal communication skills in English. Demonstrated experience and ability to build effective working relationships and to represent the department effectively in order to accomplish goals. Ability to manage multiple concurrent projects and maintain a work pace appropriate to the workload. Ability to assist individuals in recognizing and solving problems. Ability to supervise, train, motivate, provide guidance to staff. Work Environment And Physical Demands Ability to use a computer keyboard. Ability to prioritize workload and initiate action to acquire needed information from professionals by phone. Ability to function effectively with frequent interruptions and direction from multiple team members. More than 50% of work time is spent in front of a computer monitor. Must be able to lift, move, or carry objects of varying size, weighing up to 10 lbs. Some travel required (up to 25%) including occasional overnight. All HealthPlan employees are expected to: Provide the highest possible level of service to clients; Promote teamwork and cooperative effort among employees; Maintain safe practices; and Abide by the HealthPlan's policies and procedures, as they may from time to time be updated. HIRING RANGE: $136,296.78 - $177,185.82 IMPORTANT DISCLAIMER NOTICE The job duties, elements, responsibilities, skills, functions, experience, educational factors and the requirements and conditions listed in this are representative only and not exhaustive or definitive of the tasks that an employee may be required to perform. The employer reserves the right to revise this job description at any time and to require employees to perform other tasks as circumstances or conditions of its business, competitive considerations, or work environment change.

To provide daily supervision of utilization management staff. Provide departmental leadership, support, resources and direction to staff. Assists in developing and maintaining a cohesive team with a high level of productivity, accuracy and quality to achieve departmental goals and objectives. Responsibilities Provides daily leadership, direction, resources, training, evaluation, coverage and program support to assigned staff. Performs supervisory functions such as timecard management, staff scheduling to meet business requirements and directing work activities. Provides performance feedback to utilization management staff and conducting annual reviews. Participates in the interviewing, hiring and on-boarding processes of new staff. Maintains active participation with inbound and outbound provider reporting and other related duties, adjusting assignments as necessary to meet business needs and/or regulations. Documents and maintains patient-specific records in the Partnership computer system, in databases and files as applicable. Participates in committees, workgroups and/or multidisciplinary teams to support Partnership's strategic plan, organizational goals, and/or business needs. Facilitates meetings with Partnership community provider partners as a part of utilization management process. Develops and maintains positive working relationships with all business partners to ensure optimum member care and provider satisfaction. Reviews department desktops, policies and procedures, recommends changes for more efficient operations, and communicates changes and updates to staff when appropriate. Researches and responds to provider issues or barriers ensuring successful outcomes and superb customer service. Audits medical records as appropriate for accuracy, workflow evaluation, staff feedback and process improvement activities. This position, in addition to his or her own case load, may be assigned cases in the area of oversight as deemed necessary to provide coverage. Evaluates appropriateness of care through interpretation of benefits as outlined in Title 22, Medi-Cal Provider Manual, DMHC CMS regulatory requirements, Partnership Policies and Procedures, and medical necessity criteria for each product line. Researches and responds to provider issues or barriers, ensuring successful outcomes and superb customer service. Participates in special projects and assignments as required. Qualifications Education and Experience Associate or Bachelor's degree in nursing. RN with 3-5 years' experience to include staff supervision; one (1) year managed care (case management) experience; or equivalent combination of education and experience. General knowledge of managed care with emphasis in case management preferred. Special Skills, Licenses and Certifications Current California RN license. RN Supervisor will be supervising both RN and LVN staff. Case Management certification preferred. Strong knowledge of nursing requirements in a clinical setting. Knowledge of utilization management programs as related to use of pre-set criteria and protocols. Familiarity with business practices and protocols with ability to access data and information using automated systems. Ability to work within an interdisciplinary structure and function independently in a fast-paced environment while managing multiple priorities and meeting deadlines. Strong organizational skills required. Effective telephone and computer data entry skills required. Valid California Driver's License and proof of current automobile insurance compliant with Partnership's policies are required to operate a vehicle and travel for company business. Performance Based Competencies Desired competencies (ex: Knowledge of DHCS, Medi-Cal, CMS, medically necessary criteria, CalAIM and/or NCQA regulations. Ability to work within an interdisciplinary structure and function independently in a fast-paced environment while managing multiple priorities and deadlines. Strong organizational skills required. Computer literacy and proficiency. Excellent written and verbal communication skills in English. Demonstrated experience and ability to build effective working relationships and to represent the department effectively in order to accomplish goals. Ability to manage multiple concurrent projects and maintain a work pace appropriate to the workload. Ability to assist individuals in recognizing and solving problems. Ability to supervise, train, motivate, provide guidance to staff. Work Environment And Physical Demands Ability to use a computer keyboard. Ability to prioritize workload and initiate action to acquire needed information from professionals by phone. Ability to function effectively with frequent interruptions and direction from multiple team members. More than 50% of work time is spent in front of a computer monitor. Must be able to lift, move, or carry objects of varying size, weighing up to 10 lbs. Some travel required (up to 25%) including occasional overnight. All HealthPlan employees are expected to: Provide the highest possible level of service to clients; Promote teamwork and cooperative effort among employees; Maintain safe practices; and Abide by the HealthPlan's policies and procedures, as they may from time to time be updated. HIRING RANGE: $136,296.78 - $177,185.82 IMPORTANT DISCLAIMER NOTICE The job duties, elements, responsibilities, skills, functions, experience, educational factors and the requirements and conditions listed in this are representative only and not exhaustive or definitive of the tasks that an employee may be required to perform. The employer reserves the right to revise this job description at any time and to require employees to perform other tasks as circumstances or conditions of its business, competitive considerations, or work environment change.

To provide daily supervision of utilization management staff. Provide departmental leadership, support, resources and direction to staff. Assists in developing and maintaining a cohesive team with a high level of productivity, accuracy and quality to achieve departmental goals and objectives. Responsibilities Provides daily leadership, direction, resources, training, evaluation, coverage and program support to assigned staff. Performs supervisory functions such as timecard management, staff scheduling to meet business requirements and directing work activities. Provides performance feedback to utilization management staff and conducting annual reviews. Participates in the interviewing, hiring and on-boarding processes of new staff. Maintains active participation with inbound and outbound provider reporting and other related duties, adjusting assignments as necessary to meet business needs and/or regulations. Documents and maintains patient-specific records in the Partnership computer system, in databases and files as applicable. Participates in committees, workgroups and/or multidisciplinary teams to support Partnership's strategic plan, organizational goals, and/or business needs. Facilitates meetings with Partnership community provider partners as a part of utilization management process. Develops and maintains positive working relationships with all business partners to ensure optimum member care and provider satisfaction. Reviews department desktops, policies and procedures, recommends changes for more efficient operations, and communicates changes and updates to staff when appropriate. Researches and responds to provider issues or barriers ensuring successful outcomes and superb customer service. Audits medical records as appropriate for accuracy, workflow evaluation, staff feedback and process improvement activities. This position, in addition to his or her own case load, may be assigned cases in the area of oversight as deemed necessary to provide coverage. Evaluates appropriateness of care through interpretation of benefits as outlined in Title 22, Medi-Cal Provider Manual, DMHC CMS regulatory requirements, Partnership Policies and Procedures, and medical necessity criteria for each product line. Researches and responds to provider issues or barriers, ensuring successful outcomes and superb customer service. Participates in special projects and assignments as required. Qualifications Education and Experience Associate or Bachelor's degree in nursing. RN with 3-5 years' experience to include staff supervision; one (1) year managed care (case management) experience; or equivalent combination of education and experience. General knowledge of managed care with emphasis in case management preferred. Special Skills, Licenses and Certifications Current California RN license. RN Supervisor will be supervising both RN and LVN staff. Case Management certification preferred. Strong knowledge of nursing requirements in a clinical setting. Knowledge of utilization management programs as related to use of pre-set criteria and protocols. Familiarity with business practices and protocols with ability to access data and information using automated systems. Ability to work within an interdisciplinary structure and function independently in a fast-paced environment while managing multiple priorities and meeting deadlines. Strong organizational skills required. Effective telephone and computer data entry skills required. Valid California Driver's License and proof of current automobile insurance compliant with Partnership's policies are required to operate a vehicle and travel for company business. Performance Based Competencies Desired competencies (ex: Knowledge of DHCS, Medi-Cal, CMS, medically necessary criteria, CalAIM and/or NCQA regulations. Ability to work within an interdisciplinary structure and function independently in a fast-paced environment while managing multiple priorities and deadlines. Strong organizational skills required. Computer literacy and proficiency. Excellent written and verbal communication skills in English. Demonstrated experience and ability to build effective working relationships and to represent the department effectively in order to accomplish goals. Ability to manage multiple concurrent projects and maintain a work pace appropriate to the workload. Ability to assist individuals in recognizing and solving problems. Ability to supervise, train, motivate, provide guidance to staff. Work Environment And Physical Demands Ability to use a computer keyboard. Ability to prioritize workload and initiate action to acquire needed information from professionals by phone. Ability to function effectively with frequent interruptions and direction from multiple team members. More than 50% of work time is spent in front of a computer monitor. Must be able to lift, move, or carry objects of varying size, weighing up to 10 lbs. Some travel required (up to 25%) including occasional overnight. All HealthPlan employees are expected to: Provide the highest possible level of service to clients; Promote teamwork and cooperative effort among employees; Maintain safe practices; and Abide by the HealthPlan's policies and procedures, as they may from time to time be updated. HIRING RANGE: $136,296.78 - $177,185.82 IMPORTANT DISCLAIMER NOTICE The job duties, elements, responsibilities, skills, functions, experience, educational factors and the requirements and conditions listed in this are representative only and not exhaustive or definitive of the tasks that an employee may be required to perform. The employer reserves the right to revise this job description at any time and to require employees to perform other tasks as circumstances or conditions of its business, competitive considerations, or work environment change.

FLSA Status: Exempt Department: Health Services Reports To: Manager, Utilization Management The Supervisor of Utilization Management (UM) is responsible for the direct oversight of daily operations of utilization management activities, providing assistance with the development and implement of new programs and related workflows, policies, procedures for all lines of business, and serving as a resource for internal departments, members, providers, delegates, and community partners. In addition, the Supervisor of UM is responsible for supervising nurses and coordinators to ensure that all administrative UM processes are performed in accordance with all applicable state and federal regulatory requirements, SCFHP policies and procedures and business requirements. ESSENTIAL DUTIES AND RESPONSIBILITIES To perform this job successfully, an individual must be able to perform each essential duty listed below satisfactorily. 1. Collaborate with the Manager of Utilization Management to implement and supervise all UM processes for continuous and sustained compliance with all applicable state, federal and NCQA regulatory requirements, SCFHP policies and procedures and general business requirements including key performance indicators of MCAS, HEDIS, and CMS Stars for all lines of business. 2. Monitor and provide continuous analysis and quality monitoring of all policies and procedures to evaluate UM staff and delegate performance and ensure regulatory compliance, including the development and implementation of effective, measurable corrective action plans to meet targeted strategic outcomes. 3. Ensure the integration of UM operations such as prior authorization, concurrent review, Transitional Care Services (TCS), and discharge planning into other internal and external teams/departments including Quality & Process Improvement, Case Management, Community Based Programs, Pharmacy, and Behavioral Health. 4. Perform oversight and assignment of caseload across various utilization management functions including routine and ad hoc audits and monitoring of corrective action plans. 5. Establish and maintain effective interpersonal relationships with all SCFHP staff, members and/or their authorized representatives, providers and other program or agency representatives. 6. Resolve or facilitate resolution of problematic and/or complex issues by escalating to appropriate management/leadership person. 7. Ensure Utilization Management Committee preparedness. 8. Attend off-site meetings, events, or facility census review as necessary. 9. Perform other related duties as required or assigned. SUPERVISORY/MANAGEMENT RESPONSBILITIES Carries out supervisory/management responsibilities in accordance with the organization's policies, procedures, applicable regulations and laws. Responsibilities include: 1. Recruiting, interviewing, and hiring. 2. Developing a high performing department culture and staff. This includes setting the standard for staff/peers and motivating employees to maximize organizational goals and objectives. 3. Effectively assimilating, training and mentoring staff and (when appropriate), cross training existing staff and initiating retraining. This includes coaching to help increase skills, knowledge and (if applicable) improve performance. 4. Setting goals and planning, assigning, and directing work consistent with said goals. This includes responding to employees' needs, ensuring they have the necessary resources to do their work. 5. Appraising performance, rewarding and disciplining employees, addressing complaints and resolving issues. This includes providing regular and effective feedback to employees and completing timely and objective performance reviews. REQUIREMENTS - Required (R) Desired (D) The requirements listed below are representative of the knowledge, skill, and/or ability required or desired. * Unrestricted professional RN licensure in the state of California. (R) * Minimum two years of progressively responsible experience in a supervisory or lead capacity in case management, utilization management, discharge planning and/or quality improvement in a managed care related setting. (R) * Understanding and/or experience with Utilization Management. (R) * Must be knowledgeable of DHCS, CMS, DMHC regulations and NCQA Population Health Management standards. (R) * Ability to consistently meet accuracy and timeline requirements to maintain regulatory requirements. * Working knowledge of and the ability to efficiently operate all applicable computer software including computer applications such as Outlook, Word, Excel, and specific case management programs. (R) * Ability to use a keyboard with moderate speed and high level of accuracy. (R) * Excellent written, verbal, and interpersonal communication skills including the ability to express oneself clearly and concisely when providing service to SCFHP internal departments, members, providers and outside entities over the telephone, in person or in writing. (R) * Ability to comply with all SCFHP policies and procedures. (R) * Ability to think and work under pressure and effectively prioritize and complete tasks within established timeframes. (R) * Ability to assume responsibility and exercise sound judgment when making decisions within the scope of this position including performing job safely and within respect to others, to property and to individual safety (R) * Maintenance of a valid California Driver's License and acceptable driving record in order to drive to and from offsite meetings or events; or ability to use other means of transportation to attend offsite meetings or events. (R) PHYSICAL REQUIREMENTS Incumbents must be able to perform the essential functions of this job, with or without reasonable accommodation: * Mobility Requirements: regular bending at the waist, and reaching overhead, above the shoulders and horizontally, to retrieve and store files and supplies and sit or stand for extended periods of time; (R) * Lifting Requirements: regularly lift and carry files, notebooks, and office supplies that may weigh up to 5 pounds; (R) * Visual Requirements: ability to read information in printed materials and on a computer screen; perform close-up work; clarity of vision is required at 20 inches or less; (R) * Dexterity Requirements: regular use of hands, wrists, and finger movements; ability to perform repetitive motion (keyboard); writing (note-taking); ability to operate a computer keyboard and other office equipment (R) * Hearing/Talking Requirements: ability to hear normal speech, hear and talk to exchange information in person and on telephone; (R) * Reasoning Requirements: ability to think and work effectively under pressure; ability to effectively serve customers; decision making, maintain a concentrated level of attention to information communicated in person and by telephone throughout a typical workday; attention to detail. (R) ENVIRONMENTAL CONDITIONS General office conditions. May be exposed to moderate noise levels.

To provide daily supervision of utilization management staff. Provide departmental leadership, support, resources and direction to staff. Assists in developing and maintaining a cohesive team with a high level of productivity, accuracy and quality to achieve departmental goals and objectives. Responsibilities Provides daily leadership, direction, resources, training, evaluation, coverage and program support to assigned staff. Performs supervisory functions such as timecard management, staff scheduling to meet business requirements and directing work activities. Provides performance feedback to utilization management staff and conducting annual reviews. Participates in the interviewing, hiring and on-boarding processes of new staff. Maintains active participation with inbound and outbound provider reporting and other related duties, adjusting assignments as necessary to meet business needs and/or regulations. Documents and maintains patient-specific records in the Partnership computer system, in databases and files as applicable. Participates in committees, workgroups and/or multidisciplinary teams to support Partnership's strategic plan, organizational goals, and/or business needs. Facilitates meetings with Partnership community provider partners as a part of utilization management process. Develops and maintains positive working relationships with all business partners to ensure optimum member care and provider satisfaction. Reviews department desktops, policies and procedures, recommends changes for more efficient operations, and communicates changes and updates to staff when appropriate. Researches and responds to provider issues or barriers ensuring successful outcomes and superb customer service. Audits medical records as appropriate for accuracy, workflow evaluation, staff feedback and process improvement activities. This position, in addition to his or her own case load, may be assigned cases in the area of oversight as deemed necessary to provide coverage. Evaluates appropriateness of care through interpretation of benefits as outlined in Title 22, Medi-Cal Provider Manual, DMHC CMS regulatory requirements, Partnership Policies and Procedures, and medical necessity criteria for each product line. Researches and responds to provider issues or barriers, ensuring successful outcomes and superb customer service. Participates in special projects and assignments as required. Qualifications Education and Experience Associate or Bachelor's degree in nursing. RN with 3-5 years' experience to include staff supervision; one (1) year managed care (case management) experience; or equivalent combination of education and experience. General knowledge of managed care with emphasis in case management preferred. Special Skills, Licenses and Certifications Current California RN license. RN Supervisor will be supervising both RN and LVN staff. Case Management certification preferred. Strong knowledge of nursing requirements in a clinical setting. Knowledge of utilization management programs as related to use of pre-set criteria and protocols. Familiarity with business practices and protocols with ability to access data and information using automated systems. Ability to work within an interdisciplinary structure and function independently in a fast-paced environment while managing multiple priorities and meeting deadlines. Strong organizational skills required. Effective telephone and computer data entry skills required. Valid California Driver's License and proof of current automobile insurance compliant with Partnership's policies are required to operate a vehicle and travel for company business. Performance Based Competencies Desired competencies (ex: Knowledge of DHCS, Medi-Cal, CMS, medically necessary criteria, CalAIM and/or NCQA regulations. Ability to work within an interdisciplinary structure and function independently in a fast-paced environment while managing multiple priorities and deadlines. Strong organizational skills required. Computer literacy and proficiency. Excellent written and verbal communication skills in English. Demonstrated experience and ability to build effective working relationships and to represent the department effectively in order to accomplish goals. Ability to manage multiple concurrent projects and maintain a work pace appropriate to the workload. Ability to assist individuals in recognizing and solving problems. Ability to supervise, train, motivate, provide guidance to staff. Work Environment And Physical Demands Ability to use a computer keyboard. Ability to prioritize workload and initiate action to acquire needed information from professionals by phone. Ability to function effectively with frequent interruptions and direction from multiple team members. More than 50% of work time is spent in front of a computer monitor. Must be able to lift, move, or carry objects of varying size, weighing up to 10 lbs. Some travel required (up to 25%) including occasional overnight. All HealthPlan employees are expected to: Provide the highest possible level of service to clients; Promote teamwork and cooperative effort among employees; Maintain safe practices; and Abide by the HealthPlan's policies and procedures, as they may from time to time be updated. HIRING RANGE: $136,296.78 - $177,185.82 IMPORTANT DISCLAIMER NOTICE The job duties, elements, responsibilities, skills, functions, experience, educational factors and the requirements and conditions listed in this are representative only and not exhaustive or definitive of the tasks that an employee may be required to perform. The employer reserves the right to revise this job description at any time and to require employees to perform other tasks as circumstances or conditions of its business, competitive considerations, or work environment change.

Job Description BMI-PacWest, Inc. has a long tradition of excellence, proudly serving its customers for over 100 years!! We continue our legacy by providing high-quality preventive maintenance and commercial HVAC services throughout California and the Central Coast. In 2014, our company was honored as the "Family Business of the Year" at the Annual California Family Business Awards. We are seeking a dedicated Commercial HVAC Service Supervisor to join our growing team in Ventura, CA. In this role, you will provide technical support to technicians in the field, job site leadership, and day-to-day management to ensure that our service teams deliver outstanding work safely, efficiently, and to the highest standards of quality. This position requires to be on-call during after hours and on weekends if necessary. Main Job Duties: Lead and support a team of Service Technicians in the field. Repair, maintain & install commercial HVAC equipment Check on accounts and inspect work being performed Provide field service reports to the Operations Manager Oversee service projects from start to finish Take calls after hours and weekends as necessary. Ensure projects are completed on time, within budget, and meet planned gross profit goals. Ensure compliance with all codes, standards, and safety regulations. Support sales efforts by identifying opportunities, generating leads, and assisting the sales team when needed. Our Benefits: 88% Employer Covered Medical & Dental Insurance for Employee 88% Employer Covered Medical & Dental Insurance for Dependents after 3 years' service 25% 401K Match with an Annual Discretionary Gift Company-paid life insurance 9 Paid Holidays throughout the year Paid Time Off: 1 week in year 1, 2 weeks in year 2, 3 weeks following 10 years of service Company take-home vehicle and fuel card Company credit card for operations use Pay Scale: $45-$60 per hour, depending on experience Required Qualifications: HS diploma or equivalent Associate degree or Technical/Business training is a plus 7+ years of hands-on commercial HVAC experience EPA Universal and 508 certifications are required A2L refrigeration knowledge is a plus Managerial experience is preferred Ability to plan, prioritize, and direct complex projects and teams. Excellent leadership, problem-solving, and communication skills. Commitment to outstanding customer service and long-term relationship building.

As the world's largest university-based biorepository, Infinity BiologiX has been perfecting the science of biobanking, bioprocessing and analytics since 1999. By utilizing a technologically advanced infrastructure and the highest quality biomaterials, IBX scientists work to convert precious biosamples into renewable resources thereby extending research capabilities. IBX understands that research goals and objectives vary from project to project so we give each client individual and customized attention to ensure “best fit” service.As the world's largest university-based biorepository, Infinity BiologiX has been perfecting the science of biobanking, bioprocessing and analytics since 1999. By utilizing a technologically advanced infrastructure and the highest quality biomaterials, IBX scientists work to convert precious biosamples into renewable resources thereby extending research capabilities. IBX understands that research goals and objectives vary from project to project so we give each client individual and customized attention to ensure “best fit” service. Job Description POSITION SUMMARY: Reporting to the Manager, Sample Processing Services of IBX. Hours: Tuesday - Saturday 2PM - 10:30PM. This position provides managerial, high-level technical/scientific support in the operation of the IBX Cell Laboratory. The responsibilities of the position also include the training and supervision of technical staff and student workers, organizing and overseeing lab operations and new projects that require the implementation of new services, overseeing production and QC of media, working with the IT group to build workflows and database queries and generating weekly reports for upper management,. An important component of the position is high level supervision of daily and weekend processing, including coordinating team efforts and ensuring that weekend staffing meets processing demands PERFORMANCE GOALS: · This position works with the Manager and/or director of the Cell Lab to help coordinate in the following areas o Review reports/data on processes occurring in the lab for clients and other stakeholders o Help build, validate and implement SOPs for new services o Has primary responsibility for coordinating the efforts of the Cell Lab team in daily biomaterial processing, reporting to the Director and Manager of the Cell Lab on all operational aspects of management of the lab. · This position works with the Manager of the Cell Lab to ensure the smooth operation of their team such as Developing and/or implementing processes for recording data resulting in the lab, including cell culture growth, quality control test results, storage recording, and distribution tracking Submitting samples for quality testing and making decisions of resulting quality based on these results Examining chain of custody for samples, quality of reagents used in processing, laboratory conditions and technical performance. Within their own team a supervisor is responsible for o Prioritizing daily tasks Making decisions about the course of action to be taken in processing a sample o Resolving routine conflicts and issues Ensuring that staff follow standard operating protocols (SOPs) and maintain accurate data entry procedures in LIMS. o Ordering supplies and ensuring that stock inventories are maintained for all essential reagents, and overseeing ordering and installation of new equipment as well as ensuring that all equipment is maintained on appropriate schedules. o Documenting deviations and overseeing event resolutions in the QMS system Work in the lab as necessary to meet daily lab operation expectations in the event of a staffing shortage Troubleshooting processing issues including ones related to poor cell growth and culture contamination Ensuring that the team remains up-to-date on training, including but not limited to SOP training, competency training, regulatory training and safety training Qualifications COMPETENCIES: Must be proficient in all aspects of blood processing and cell culture, passaging and cryopreservation. Must be well-organized Ability to conduct and organize laboratory based business enterprise efficiently and expeditiously while maintaining a high level of accuracy and attention to detail. · Works independently with minimal supervision. QUALIFICATIONS: Requires a Bachelors or Masters degree in a Life Sciences field with 5 or more years of experience in advanced laboratory operations. Masters degree in a life science is preferred Must have several years experience supervising and managing a high volume complex laboratory of 5 or more individuals that coordinates activities with multiple other divisions and external laboratories. Detailed working knowledge of cell biology and cell culture techniques. This knowledge is essential for training, supervision and evaluating technical staff. Additional Information All your information will be kept confidential according to EEO guidelines.

As the world's largest university-based biorepository, Infinity BiologiX has been perfecting the science of biobanking, bioprocessing and analytics since 1999. By utilizing a technologically advanced infrastructure and the highest quality biomaterials, IBX scientists work to convert precious biosamples into renewable resources thereby extending research capabilities. IBX understands that research goals and objectives vary from project to project so we give each client individual and customized attention to ensure “best fit” service.As the world's largest university-based biorepository, Infinity BiologiX has been perfecting the science of biobanking, bioprocessing and analytics since 1999. By utilizing a technologically advanced infrastructure and the highest quality biomaterials, IBX scientists work to convert precious biosamples into renewable resources thereby extending research capabilities. IBX understands that research goals and objectives vary from project to project so we give each client individual and customized attention to ensure “best fit” service. Job Description POSITION SUMMARY: Reporting to the Manager, Sample Processing Services of IBX. Hours: Tuesday - Saturday 2PM - 10:30PM. This position provides managerial, high-level technical/scientific support in the operation of the IBX Cell Laboratory. The responsibilities of the position also include the training and supervision of technical staff and student workers, organizing and overseeing lab operations and new projects that require the implementation of new services, overseeing production and QC of media, working with the IT group to build workflows and database queries and generating weekly reports for upper management,. An important component of the position is high level supervision of daily and weekend processing, including coordinating team efforts and ensuring that weekend staffing meets processing demands PERFORMANCE GOALS: · This position works with the Manager and/or director of the Cell Lab to help coordinate in the following areas o Review reports/data on processes occurring in the lab for clients and other stakeholders o Help build, validate and implement SOPs for new services o Has primary responsibility for coordinating the efforts of the Cell Lab team in daily biomaterial processing, reporting to the Director and Manager of the Cell Lab on all operational aspects of management of the lab. · This position works with the Manager of the Cell Lab to ensure the smooth operation of their team such as Developing and/or implementing processes for recording data resulting in the lab, including cell culture growth, quality control test results, storage recording, and distribution tracking Submitting samples for quality testing and making decisions of resulting quality based on these results Examining chain of custody for samples, quality of reagents used in processing, laboratory conditions and technical performance. Within their own team a supervisor is responsible for o Prioritizing daily tasks Making decisions about the course of action to be taken in processing a sample o Resolving routine conflicts and issues Ensuring that staff follow standard operating protocols (SOPs) and maintain accurate data entry procedures in LIMS. o Ordering supplies and ensuring that stock inventories are maintained for all essential reagents, and overseeing ordering and installation of new equipment as well as ensuring that all equipment is maintained on appropriate schedules. o Documenting deviations and overseeing event resolutions in the QMS system Work in the lab as necessary to meet daily lab operation expectations in the event of a staffing shortage Troubleshooting processing issues including ones related to poor cell growth and culture contamination Ensuring that the team remains up-to-date on training, including but not limited to SOP training, competency training, regulatory training and safety training Qualifications COMPETENCIES: Must be proficient in all aspects of blood processing and cell culture, passaging and cryopreservation. Must be well-organized Ability to conduct and organize laboratory based business enterprise efficiently and expeditiously while maintaining a high level of accuracy and attention to detail. · Works independently with minimal supervision. QUALIFICATIONS: Requires a Bachelors or Masters degree in a Life Sciences field with 5 or more years of experience in advanced laboratory operations. Masters degree in a life science is preferred Must have several years experience supervising and managing a high volume complex laboratory of 5 or more individuals that coordinates activities with multiple other divisions and external laboratories. Detailed working knowledge of cell biology and cell culture techniques. This knowledge is essential for training, supervision and evaluating technical staff. Additional Information All your information will be kept confidential according to EEO guidelines.

Blue Cross and Blue Shield of Kansas is looking to add to our Finance team and has an opportunity for a Manager Corporate Finance and Decision Support. This position Support plays a pivotal role in the development and execution of the Financial Planning and Analysis (FP&A) function. Leading a team of financial analysts, this position provides strategic financial guidance and analysis to drive data-driven decisions at the executive level. The manager collaborates with cross-functional teams to develop comprehensive financial strategies, ensure effective budgeting and forecasting, and support business growth initiatives. This position works closely with the Director of FP&A to align financial planning efforts with the company's overall strategic goals and objectives. “This position is eligible to work hybrid or onsite in accordance with our Telecommuting Policy. Applicants must reside in Kansas or Missouri or be willing to relocate as a condition of employment.” Are you ready to make a difference? Choose to work for one of the most trusted companies in Kansas. Why Join Us? Lead and Inspire: Guide and mentor your team to achieve their full potential and success. Family Comes First: Total rewards package that promotes the idea of family first for all employees. Professional Growth Opportunities: Advance your career with ongoing training and development programs. Trust: Work for one of the most trusted companies in Kansas Compensation $116,000 - $145,000 Exempt Grade 18 Blue Cross and Blue Shield of Kansas offers excellent competitive compensation with the goal of retaining and growing talented team members. The compensation range for this role is a good faith estimate, it is estimated based on what a successful candidate might be paid. All offers presented to candidates are carefully reviewed to ensure fair, equitable pay by offering competitive wages that align with the individual's skills, education, experience, and training. The range may vary above or below the stated amounts. What you'll do Collaborate with finance business partners to manage the annual budgeting process, gather financial insights from divisional leaders, and develop accurate and realistic corporate budgets and forecasts. Ensure alignment with the company's strategic objectives. Prepare, synthesize, and present comprehensive financial reports and presentations to senior management and key stakeholders. Highlight key findings, trends, and actionable recommendations for business performance improvements. Monitor financial performance against corporate targets and budgets. Conduct in-depth analyses of financial data to identify trends, risks, and opportunities for improvement. Address discrepancies and work with teams to implement corrective actions where necessary. Partner with the Business Intelligence team to develop KPIs and other decision-support measures to guide business strategy. Ensure that analytics and reporting frameworks provide the insights necessary for executive decision-making. Build and maintain scalable financial models that generate actionable insights for business and investment decisions. Leverage scenario analysis to evaluate potential opportunities and risks, providing the executive team with data-driven recommendations. Support the development of business cases and financial strategies for key growth initiatives, including mergers and acquisitions (M&A), product launches, market expansion, and margin improvement efforts. Analyze financial impacts and recommend strategies that drive sustainable growth. Stay informed on general economic, competitive, and market conditions, communicating relevant financial implications to stakeholders. Provide actionable insights on how these factors could impact business operations. Ensure compliance with financial regulations and corporate policies. Collaborate with external auditors and regulatory bodies as needed to ensure adherence to best practices and legal requirements. Partner with the Financial Information Systems team to improve Adaptive Insights functionality. Drive initiatives to automate reporting processes, streamline financial planning systems, and continuously improve forecast and budgeting models. Drive improvements to financial models and reporting processes as the business evolves. Develop repeatable, scalable processes for financial planning, reporting, and forecasting to enhance accuracy and efficiency. What you need Bachelor's degree in accounting, finance or related field required 3 years leadership experience required Knowledge/Skills/Abilities Exceptionally strong analytical abilities, with a track record of identifying insights from financial information and translating into business analytics and recommendations Proficiency in accounting software and ERP systems; experience with Adaptive Insights preferred. Strong analytical and problem-solving skills Strong interpersonal and communication skills, with the ability to work collaboratively across departments. High level of integrity and strong attention to detail. Bonus if you have 5 years of progressive experience in financial planning and analysis role; substantial financial modeling and/or scenario planning experience preferred Benefits & Perks Base compensation is only one component of your competitive Total Rewards package Incentive pay program (EPIP) Health/Vision/Dental insurance 6 weeks paid parental leave for new mothers and fathers Fertility/Adoption assistance 2 weeks paid caregiver leave 5% 401(k) plan matching Tuition reimbursement Health & fitness benefits, discounts and resources Our Commitment to Connection and Belonging At Blue Cross and Blue Shield of Kansas, we are committed to fostering a culture of connection and belonging, where mutual respect is at the foundation of our workplace. We provide equal employment opportunities to all individuals, regardless of race, color, religion, belief, sex, pregnancy (including childbirth, lactation, and related medical conditions), national origin, age, physical or mental disability, marital status, sexual orientation, gender identity, gender expression, genetic information (including characteristics and testing), military or veteran status, family or parental status, or any other characteristic protected by applicable law. Blue Cross and Blue Shield of Kansas conducts pre-employment drug screening, criminal conviction check, employment verifications and education as part of a conditional offer of employment.

Blue Cross and Blue Shield of Kansas is looking to add to our Finance team and has an opportunity for a Manager Corporate Finance and Decision Support. This position Support plays a pivotal role in the development and execution of the Financial Planning and Analysis (FP&A) function. Leading a team of financial analysts, this position provides strategic financial guidance and analysis to drive data-driven decisions at the executive level. The manager collaborates with cross-functional teams to develop comprehensive financial strategies, ensure effective budgeting and forecasting, and support business growth initiatives. This position works closely with the Director of FP&A to align financial planning efforts with the company's overall strategic goals and objectives. "This position is eligible to work hybrid or onsite in accordance with our Telecommuting Policy. Applicants must reside in Kansas or Missouri or be willing to relocate as a condition of employment." Are you ready to make a difference? Choose to work for one of the most trusted companies in Kansas. Why Join Us? * Lead and Inspire: Guide and mentor your team to achieve their full potential and success. * Family Comes First: Total rewards package that promotes the idea of family first for all employees. * Professional Growth Opportunities: Advance your career with ongoing training and development programs. * Trust: Work for one of the most trusted companies in Kansas Compensation $116,000 - $145,000 Exempt Grade 18 * Blue Cross and Blue Shield of Kansas offers excellent competitive compensation with the goal of retaining and growing talented team members. The compensation range for this role is a good faith estimate, it is estimated based on what a successful candidate might be paid. All offers presented to candidates are carefully reviewed to ensure fair, equitable pay by offering competitive wages that align with the individual's skills, education, experience, and training. The range may vary above or below the stated amounts. What you'll do * Collaborate with finance business partners to manage the annual budgeting process, gather financial insights from divisional leaders, and develop accurate and realistic corporate budgets and forecasts. Ensure alignment with the company's strategic objectives. * Prepare, synthesize, and present comprehensive financial reports and presentations to senior management and key stakeholders. Highlight key findings, trends, and actionable recommendations for business performance improvements. * Monitor financial performance against corporate targets and budgets. Conduct in-depth analyses of financial data to identify trends, risks, and opportunities for improvement. Address discrepancies and work with teams to implement corrective actions where necessary. * Partner with the Business Intelligence team to develop KPIs and other decision-support measures to guide business strategy. Ensure that analytics and reporting frameworks provide the insights necessary for executive decision-making. * Build and maintain scalable financial models that generate actionable insights for business and investment decisions. Leverage scenario analysis to evaluate potential opportunities and risks, providing the executive team with data-driven recommendations. * Support the development of business cases and financial strategies for key growth initiatives, including mergers and acquisitions (M&A), product launches, market expansion, and margin improvement efforts. Analyze financial impacts and recommend strategies that drive sustainable growth. * Stay informed on general economic, competitive, and market conditions, communicating relevant financial implications to stakeholders. Provide actionable insights on how these factors could impact business operations. * Ensure compliance with financial regulations and corporate policies. Collaborate with external auditors and regulatory bodies as needed to ensure adherence to best practices and legal requirements. * Partner with the Financial Information Systems team to improve Adaptive Insights functionality. Drive initiatives to automate reporting processes, streamline financial planning systems, and continuously improve forecast and budgeting models. * Drive improvements to financial models and reporting processes as the business evolves. Develop repeatable, scalable processes for financial planning, reporting, and forecasting to enhance accuracy and efficiency. What you need * Bachelor's degree in accounting, finance or related field required * 3 years leadership experience required Knowledge/Skills/Abilities * Exceptionally strong analytical abilities, with a track record of identifying insights from financial information and translating into business analytics and recommendations * Proficiency in accounting software and ERP systems; experience with Adaptive Insights preferred. * Strong analytical and problem-solving skills * Strong interpersonal and communication skills, with the ability to work collaboratively across departments. * High level of integrity and strong attention to detail. Bonus if you have * 5 years of progressive experience in financial planning and analysis role; substantial financial modeling and/or scenario planning experience preferred Benefits & Perks * Base compensation is only one component of your competitive Total Rewards package * Incentive pay program (EPIP) * Health/Vision/Dental insurance * 6 weeks paid parental leave for new mothers and fathers * Fertility/Adoption assistance * 2 weeks paid caregiver leave * 5% 401(k) plan matching * Tuition reimbursement * Health & fitness benefits, discounts and resources Our Commitment to Connection and Belonging At Blue Cross and Blue Shield of Kansas, we are committed to fostering a culture of connection and belonging, where mutual respect is at the foundation of our workplace. We provide equal employment opportunities to all individuals, regardless of race, color, religion, belief, sex, pregnancy (including childbirth, lactation, and related medical conditions), national origin, age, physical or mental disability, marital status, sexual orientation, gender identity, gender expression, genetic information (including characteristics and testing), military or veteran status, family or parental status, or any other characteristic protected by applicable law. Blue Cross and Blue Shield of Kansas conducts pre-employment drug screening, criminal conviction check, employment verifications and education as part of a conditional offer of employment.

Department: CASE MANAGEMENT Job Type: Regular Employment Type: Full-Time Salary Range: $123,588.00 - $123,588.00 Empower. Unite. Care. MetroPlusHealth is committed to empowering New Yorkers by uniting communities through care. We believe that Health care is a right, not a privilege. If you have compassion and a collaborative spirit, work with us. You can come to work being proud of what you do every day. About NYC Health + Hospitals MetroPlusHealth provides the highest quality healthcare services to residents of Bronx, Brooklyn, Manhattan, Queens and Staten Island through a comprehensive list of products, including, but not limited to, New York State Medicaid Managed Care, Medicare, Child Health Plus, Exchange, Partnership in Care, MetroPlus Gold, Essential Plan, etc. As a wholly-owned subsidiary of NYC Health + Hospitals, the largest public health system in the United States, MetroPlusHealth's network includes over 27,000 primary care providers, specialists and participating clinics. For more than 40 years, MetroPlusHealth has been committed to building strong relationships with its members and providers. Position Overview Under the direction of the Director of Medicaid, the Medicaid Care Manager Team Lead ensures that staff adhere to the Medicaid contractual requirements, policies and procedures, and workflows established to manage the vulnerable Medicaid population. The Medicaid Care Manager Team Lead manages the daily activities of the Medicaid team (Care Managers and Care Management Associates) to ensure quality outcomes in the delivery of member-centered case management including reduction in emergency room visits and hospital admissions, improved member satisfaction, improved member health, and cost effectiveness. Work Shifts 9:00 A.M - 5:00 P.M Duties & Responsibilities * Provide clinical guidance and supervision to assigned Care Managers and clinical support staff to promote efficient and effective delivery of care management services * Supervise day to day activities to make certain that case management services are provided in accordance with clinical guidelines, established processed and MetroPlusHealth organizational standards. * Supervise the entire care management workflow including case referrals, assignments, interventions and goal setting, follow-up/follow-through activities, documentations, and escalations. * Ensure care management activities are conducted in a safe, efficient, and effective manner to promote continuity and quality of care. * Review, develop and modify day to day workflows to ensure timely follow up. * Perform ongoing quality review of cases to ensure accuracy and compliance. * Evaluate and document staff performance; coach staff to improve both quality and quantity of skills attaining optimal performances. * Utilize data to track, trend and report productivity and outcome measures, work with the management team to implement necessary improvement strategies. * Coordinate Interdisciplinary Care Team rounds with providers, care managers and care management associates, this include scheduling meetings, identifying members for presentation, and ensuring completion and documentation of follow up activities. * Collaborate Behavioral Health to develop strategies and best practices that lead to desired goals and objectives for members who are co-managed. * Use expert verbal and non-verbal communication skills to motivate and gain co-operation of members and their caregivers. * Resolve issues and mitigate conflict encountered during daily operations, appropriately escalate issues to the Director of Medicaid * Identify and report potential risk, operational opportunities, and barriers encountered. * Conduct monthly audits for the purpose of departmental/organizational reporting and providing formal feedback to case management staff. * Create and submit operational weekly/monthly/quarterly reports. * Work with the leadership team to develop and implement ongoing training and development efforts. * Actively participate in staff training and meetings. * Encourage regular communication and inform staff of relevant departmental and organizational updates. * Develop and maintain collaborative relationships with clinical providers, facility staff and community resources. * Ensure staff comply with orientation requirements, annual and other mandatory trainings, organizational and departmental policies, and procedures. * Perform other duties as assigned by Director. Minimum Qualifications * Bachelor's Degree required, Master's in nursing preferred. * A minimum of 5 years of Care Management experience in a health care and/or Managed Care setting required. * Minimum of 2 years managerial/leadership experience in a Managed Care and/or healthcare setting required. * Proficiency with computers navigating in multiple systems and web-based applications. * Must know how to use Microsoft Office applications including Word, Excel, and PowerPoint and Outlook. * Ability to proficiently read and interpret medical records, claims data, pharmacy and lab reports, and prescriptions required * Valid New York State license and current registration to practice as a Registered Professional Nurse (RN) Issued by the New York State Education Department (NYSED). * Integrity and Trust * Customer Focus * Functional/Technical Skills * Confident, autonomous, solution driven, detail oriented, nonjudgmental, diplomatic, resourceful, intuitive, dedicated, resilient and proactive. * Strong verbal and written communication skills including motivational coaching, influencing, and negotiation abilities. * Holds themselves to high standards of excellence * Time management and organizational skills. * Strong problem-solving skills. * Ability to prioritize and manage changing priorities under pressure. * Ability to work closely with member and caregiver. * Ability to form effective working relationships with a wide range of individuals. #MPH50 #LI-Hybrid Benefits NYC Health and Hospitals offers a competitive benefits package that includes: * Comprehensive Health Benefits for employees hired to work 20+ hrs. per week * Retirement Savings and Pension Plans * Paid Holidays and Vacation in accordance with employees' Collectively bargained contracts * Loan Forgiveness Programs for eligible employees * College tuition discounts and professional development opportunities * College Savings Program * Union Benefits for eligible titles * Multiple employee discounts programs * Commuter Benefits Programs

Monitor the performance and address issues with any business partners or vendors that supports the Members Servicing Department. Build relationships with both internal and external customers to include members and employer groups to address issues and concerns and improve the customer experience. Recruit and retain effective teams through selection, development, compensation and motivation of personnel; develop talents necessary to achieve short- and long-term objectives through effective training, mentoring and coaching. Provides feedback and guidance, including timely completion of interim and annual performance reviews. Monitors overall workflow and prioritizes staff's work. Review financial information and adjust operational budgets to promote and demonstrate desired corporate financial stewardship and outcomes. Performs all other miscellaneous responsibilities and duties as assigned or directed. #LI-Hybrid

* Monitor the performance and address issues with any business partners or vendors that supports the Members Servicing Department. * Build relationships with both internal and external customers to include members and employer groups to address issues and concerns and improve the customer experience. * Recruit and retain effective teams through selection, development, compensation and motivation of personnel; develop talents necessary to achieve short- and long-term objectives through effective training, mentoring and coaching. Provides feedback and guidance, including timely completion of interim and annual performance reviews. Monitors overall workflow and prioritizes staff's work. * Review financial information and adjust operational budgets to promote and demonstrate desired corporate financial stewardship and outcomes. * Performs all other miscellaneous responsibilities and duties as assigned or directed. #LI-Hybrid * Bachelor's degree and three years related work experience; or an equivalent combination of education and related experience. * One year of leadership, supervisory, or management experience. * Excellent verbal and written communication skills. * Intermediate working knowledge of Microsoft Work and Outlook. * Basic working knowledge of Microsoft Excel and PowerPoint.