Supervisor, Clinical Intake (Remote)

Imagine360 is seeking a Supervisor, Clinical Intake to join the team!  The Supervisor, Clinical Intake is responsible for leading a team by providing oversight and guidance on Medical Management non-clinical tasks, processes, and operations. The Supervisor is also responsible for supporting projects across the team and department and additional tasks as needed.

Position Location: 100% remote

Responsibilities include but are not limited to:

Supervisory Responsibilities:

• Medical Intake Specialists
  
  
  

Duties/Responsibilities:

Responsible for the day-to-day management, oversight, and guidance for the Medical Intake team and their associated tasks; works with employees to problem solve and make operational processes most efficient.

Responsible for the call queue and appropriate staffing to maintain abandonment rate

Responsible for the performance management and corrective action process for all team members in partnership with the Senior Manager.

Perform monthly 1:1 coaching with each MIS staff for quality improvement and metrics.

Perform monthly call and chart audit for the MIS staff and reports to UM Manager/Senior Manager.

Review QA results to develop educational opportunities for the MIS staff and completes performance improvement plans for scores <90% per policies and procedures.

Review and manage approvals and communications for PTO requests by employees, as directed by the Manager or Senior Manager.

Develop training, maintain training materials, and facilitate training for existing and new team members.

Lead the interviewing and hiring processes as needed with UM Supervisor or Manager.

Act as role model within a team setting to provide mentoring, coaching, and positive outcomes for employees, peers, and overall operations.

Appropriately escalates difficult issues as needed.

Develop daily workflow processes and procedures, as well as develops and implements non-clinical policies and procedures.

Support the process to appropriately distribute and prioritize calls received in the telephonic intake queue for the team.

Refer to licensed clinical staff for oversight/review of clinical information as instructed.

Create and distribute reports for the department and team as need by internal or external requests for data.

Based on high volumes, will manage or delegate daily medical intake tasks and calls. Will create and assign program-specific tasks following approved criteria for task assignments.

• Accurately identify and provide HIPAA compliant information to callers regarding medical services requiring notification per Medical Management Notification Policy and Procedures.
• Complete data entry of notification and obtain clinical information and/or results of diagnostic testing as indicated per the Medical Management Notification Policy and Procedure in times of high case/call volume.
• Contact provider/facility to confirm the date of service, as indicated per Medical Management Notification Policy & Procedure, with appropriate documentation in case tracking software in compliance with Medical Management Policies and Procedures
• Consistently complete appropriate documentation in software including but not limited to CaseTrakker, GBAS and Docushare per Medical Management Policy and Procedures
• Consistently demonstrate engagement in professional conversation in all internal and external communications (verbal and/or electronic)

Participate in Medical Management quality programs, as well as provide support and project coordination for Medical Management quality initiatives as needed.

Lead bi-monthly meetings for MIS team, will participate in department wide meetings and trainings or other job specific events as required by teleconference or onsite.

Work collaboratively and cross functionally across the Medical Management department.

Submit IT tickets on system issues as needed for the team.

Communicate proactively and effectively with internal or external peers and leadership.

Support other tasks and projects as needed across the department, on time and accurately.

Perform all tasks in accordance with HIPAA/PHI guidelines.

Adhere to established internal regulations regarding Department of Labor, HIPAA, ERISA and department and company policies and procedures.

Complete HIPAA training and Trainings assigned by quality team monthly/annually.

Required Experience/Education:

Required Education:

• High school degree or equivalent experience.
  
  
  

Preferred Education:

• Bachelor's degree preferred but not required.
  
  
  

Preferred experience:

Required Experience:

• 3 years' experience in an administrative or operational role.
• Proven success in managing tasks accurately and on time.
• Experience maintaining a high level of accuracy and attention to detail to perform each essential duty satisfactorily.
• Advance knowledge and skills using Microsoft Office including Word, Excel, and PowerPoint software; Internet software; Database software.
  
  
  

Preferred Experience:

• Prior experience leading a team and managing direct reports.
• Success at leading process improvement initiatives.

Browse our curated collection of remote jobs across all categories and industries, featuring positions from top companies worldwide.

• Administrative and operational experience within the healthcare industry preferred.
  
  
  

Skills and Abilities:

• Ability to read and interpret documents such as HIPAA compliance, safety rules, operating and maintenance instructions, and policy and procedure manuals.
• Ability to apply common sense understanding to carry out instructions furnished in written, oral, or diagram form.
• Ability to deal with problems and exercise sound judgment involving several concrete variables in standardized situations.
• Ability to resolve problems independently and demonstrate ability to multi-task.
• Strong verbal and written communication skills.
• Strong presentation skills.
• Ability to demonstrate a commitment to building new skills and fostering a positive work environment within a team setting.
  
  
  

What can Imagine360 offer you?

• Multiple Health plan options
• Company paid employee premiums for disability and life insurance
• Parental Leave Policy
• 20 days PTO to start / 10 Paid Holidays
• Tuition reimbursement
• 401k Company contribution
• Company paid Short & Long term Disability plus Life Insurance
• Professional development initiatives / continuous learning opportunities
• Opportunities to participate in and support the company's diversity and inclusion initiatives
  
  
  

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Imagine360 is a health plan solution company that combines 50+ years of self-funding healthcare expertise. Over the years, we've helped thousands of employers save billions on healthcare. Our breakthrough total health plan solution is fixing today's one-size-fits-none PPO insurance problems with powerful, customized, member-focused solutions.

Imagine360 is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or veteran status.

**RECRUITMENT AGENCIES PLEASE NOTE: Imagine360 will only accept applications from agencies/business partners that have been invited to work on a specific role. Candidate Resumes/CV's submitted without permission or directly to Hiring Managers will be considered unsolicited and no fee will be payable. Thank you for your cooperation**