Supervisor Health Plan Operations

Description

Organizes and directs the daily activities and department workflows of USFHP operational departments under the supervision of the Director of USFHP Operations. Responsibilities include ensuring accurate and timely service delivery in keeping with the requirements of the operational area(s). Provides training and assures compliance with Department of Defense (DoD) / Defense Health Agency (DHA) and other government agency guidelines and contract requirements. Sets department policy and monitors compliance with same. Ensures standards are met. Prepares monthly, quarterly, annual and ad hoc reporting and conducts audits to assure continued compliance with standards. Monitors TRICARE and other pertinent regulatory guidelines and educates staff of changes. Identifies and solves issues with outside providers / vendors. Serves as the principal department contact with IT for managed care operations platforms. Manages revisions / upgrades to software as relates to the pertinent department(s). Responsible for storage and retrieval of department documentation in keeping with the Defense Health Agency (DHA) Records Management requirements. Serves as a member of the US Family Health Plan management team. Participates in managing the US Family Health Plan budget with the Director of USFHP Operations and the other members of the management team.

Providence caregivers are not simply valued - they're invaluable. Join our team at Pacmed Clinics DBA Pacific Medical Centers and thrive in our culture of patient-focused, whole-person care built on understanding, commitment, and mutual respect. Your voice matters here, because we know that to inspire and retain the best people, we must empower them.

Required Qualifications :

• 4 years Health care claims experience.
• 2 years Supervisory capacity, including Lead role; or six months supervisory experience within Pacific Medical Centers.

Preferred Qualifications :

Why Join Providence?

Our best-in-class benefits are uniquely designed to support you and your family in staying well, growing professionally, and achieving financial security. We take care of you, so you can focus on delivering our Mission of caring for everyone, especially the most vulnerable in our communities.

About Providence

At Providence, our strength lies in Our Promise of "Know me, care for me, ease my way." Working at our family of organizations means that regardless of your role, we'll walk alongside you in your career, supporting you so you can support others. We provide best-in-class benefits and we foster an inclusive workplace where diversity is valued, and everyone is essential, heard and respected. Together, our 120,000 caregivers (all employees) serve in over 50 hospitals, over 1,000 clinics and a full range of health and social services across Alaska, California, Montana, New Mexico, Oregon, Texas and Washington. As a comprehensive health care organization, we are serving more people, advancing best practices and continuing our more than 100-year tradition of serving the poor and vulnerable.

The amounts listed are the base pay range; additional compensation may be available for this role, such as shift differentials, standby / on-call, overtime, premiums, extra shift incentives, or bonus opportunities.

Providence offers a comprehensive benefits package including a retirement 401(k) Savings Plan with employer matching, health care benefits (medical, dental, vision), life insurance, disability insurance, time off benefits (paid parental leave, vacations, holidays, health issues), voluntary benefits, well-being resources and much more. Learn more at providence.jobs / benefits.

Applicants in the Unincorporated County of Los Angeles : Qualified applications with arrest or conviction records will be considered for employment in accordance with the Unincorporated Los Angeles County Fair Chance Ordinance for Employers and the California Fair Chance Act."

About the Team

Pacific Medical Centers (PacMed) is a private, not-for-profit, primary and integrated multi-specialty health care network with outpatient clinics and primary and specialty care providers in King, Snohomish and Pierce counties. We combine decades of patient-centered care with cutting-edge technology, first-class facilities and board-certified providers.

Our strong team environment and respect for our people-at all levels and from all backgrounds-allow us to provide authentic care that achieves the highest-quality patient outcomes, backed by the strong network of resources and support through our affiliation with the Providence family, including local partners like Swedish Health Services.

Providence is proud to be an Equal Opportunity Employer. We are committed to the principle that every workforce member has the right to work in surroundings that are free from all forms of unlawful discrimination and harassment on the basis of race, color, gender, disability, veteran, military status, religion, age, creed, national origin, sexual identity or expression, sexual orientation, marital status, genetic information, or any other basis prohibited by local, state, or federal law. We believe diversity makes us stronger, so we are dedicated to shaping an inclusive workforce, learning from each other, and creating equal opportunities for advancement.

For any concerns with this posting relating to the posting requirements in RCW 49.58.110(1), please click here where you can access an email link to submit your concern.

Requsition ID : 392655

Company : Pacific Medical Jobs

Job Category : Member Services Enrollment & Billing

Job Function : Health Plans Services

Job Schedule : Full time

Job Shift : Day

Career Track : Leadership

Department : 3060 WA USFHP

Address : WA Seattle 1226 S Judkins St

Work Location : PACMED Q5-Seattle

Workplace Type : On-site

Pay Range : $39.45 - $61.24

The amounts listed are the base pay range; additional compensation may be available for this role, such as shift differentials, standby / on-call, overtime, premiums, extra shift incentives, or bonus opportunities.