Supervisor, Clinical Operations at Blue Cross of Idaho
Meridian, Idaho, USA -
Full Time


Start Date

Immediate

Expiry Date

12 Oct, 25

Salary

94066.0

Posted On

13 Jul, 25

Experience

2 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

No

Skills

Cms, Utilization Management, Medicare, Critical Thinking, Handle Multiple Projects

Industry

Hospital/Health Care

Description

Blue Cross of Idaho is seeking a Supervisor to supervise staff performing utilization and case management activities. Support critical initiatives by developing programs, evaluating processes and performance for Medicare Advantage, Commercial, and Federal Employee Plan (FEP) Lines of Business.
We’re looking for a Supervisor with:
Experience: 5 years’ relevant experience
Education: Associate Degree in Nursing or Bachelor’s Degree in Social Work; or equivalent work experience (Two years’ relevant work experience is equivalent to one-year college)

Licenses/Certifications: Must hold one of the following:

  • Valid unrestricted Idaho Registered Nurse Licensure
  • Valid unrestricted Idaho Social Work License

Preferred Qualification:

  • Master’s degree in Social Work

What a day of a Supervisor would look like:

  • Provide day-to-day oversight of the functional area assigned.
  • Monitor quality performance measures and confirms appropriate completion of work assignments.
  • Provides input and support for changes to applicable systems and processes.
  • Provide guidance, counseling, coaching, and continuing education opportunities to staff. Selects, develops, mentors, and assesses performance of staff.
  • Participate in process improvement initiatives and implements outcomes.
  • Assist in the development of departmental policies, procedures, service standards, and workflows.
  • Develop, and maintains department specific documentation, to include policies, procedures, service standards, and workflows.
  • May participate in goal setting process for the unit and/or department.
  • May design, update, and maintain special programs.
  • May participate in internal/external audits.
  • Performs other duties and responsibilities as assigned.

Additional skills that we are looking for:

  • High degree verbal and written communication
  • Independent and critical thinking
  • Handle multiple projects simultaneously
  • Handle questions and inquiries regarding medical decisions for staff
  • Utilization management
  • National Commission on Quality Assurance (NCQA) accreditation standards
  • Center for Medicare and Medicaid Services (CMS)

As of the date of this posting, a good faith estimate of the current pay range is $94,066 to $141,100. The position is eligible for an annual incentive bonus (variable depending on company and employee performance.
The pay range for this position takes into account a wide range of factors including, but not limited to, specific competencies, relevant education, qualifications, certifications, relevant experience, skills, seniority, performance, shift, travel requirements, internal equity, geography, business or organizational needs, and alignment with market data. At Blue Cross of Idaho, it is not typical for an individual to be hired at or near the top range for the position. Compensation decisions are dependent on factors and circumstances at the time of offer.
We offer a robust package of benefits including paid time off, paid holidays, community service and self-care days, medical/dental/vision/pharmacy insurance, 401(k) matching and non-contributory plan, life insurance, short and long term disability, education reimbursement, employee assistance plan (EAP), adoption assistance program and paid family leave program.
We will adhere to all relevant state and local laws concerning employee leave benefits, in line with our plans and policies.
Reasonable accommodations
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed above are representative of the knowledge, skill and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
We are an Equal Opportunity Employer and do not discriminate against any employee or applicant for employment because of race, color, sex, age, national origin, religion, sexual orientation, gender identity, status as a veteran, and basis of disability or any other federal, state or local protected class

Responsibilities

Please refer the Job description for details

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