Manager, Healthcare Services Operations Support

Job description

JOB DESCRIPTION Job Summary Leads and manages a team supporting non-clinical healthcare services activities for care management, care review, utilization management, transitions of care, behavioral health, long-term services and supports (LTSS), and/or other program specific service support - ensuring members reach desired outcomes through integrated delivery of care across the continuum. Contributes to overarching strategy to provide quality and cost-effective member care. Essential Job Duties: - Provides oversight for non-clinical operational teams that support one or more of the following healthcare services functions: care review, utilization management (prior authorizations, inpatient/outpatient medical necessity, etc.), care management, transitions of care, health management, long-term services and supports (LTSS), behavioral health, member assessment and/or other special programs. - Facilitates integrated proactive management, ensuring compliance with state, federal, regulatory and accrediting standards. - Responsible for selection, orientation, onboarding and training of new staff - Manages and evaluates team member performance and provides coaching, mentoring, employee dev...