Supervisor Long Term Support Services

CalOptima Health is seeking a highly motivated an experienced Supervisor Long Term Support Services to join our team. The Supervisor, Long Term Support Services will be responsible for planning, organizing, developing and implementing the principles, programs, policies and procedures employed in the delivery of Long Term Services and Supports (LTSS) to members in the community and institutionalized settings. The incumbent will be responsible for the management of the day-to-day operational activities for LTSS programs: Long Term Care (LTC), Community Based Adult Services (CBAS) and CalAIM (Enhanced Care Management (ECM) and Community Supports (CS)), while interacting with internal/external management staff, providers, vendors, health networks and other internal and external customers in a professional, positive and competent manner. The incumbent will be responsible for supervising and monitoring the ongoing and daily activities of the department staff. In addition, the incumbent will resolve members' and providers' issues and barriers ensuring excellent customer service. The incumbent will manage staff coverage in all areas of LTSS to complete all assignments, the orienting and training of new employees and ensure contractual and regulatory requirements are met.

Position Information:

• Department: Long Term Care
• Salary Grade: N - $95,000 - $155,078 ($45.67 - $74.5567)
• Work Arrangement: Partial Telework
  
  **This position is eligible for telework in California.**

Duties & Responsibilities:

• 80% - Supervisory
  • Participates in a mission-driven culture of high-quality performance, with a member focus on customer service, consistency, dignity and accountability.
  • Assists the team in carrying out department responsibilities and collaborates with others to support short- and long-term goals/priorities for the department.
  • Supervises, trains and audits the LTSS Medical Case Managers, Social Workers, Program Specialists and non-clinical staff such as Personal Care Coordinators (PCC), Medical Authorization Assistants (MAA) and Administrative Assistants (AA) per Medi-Cal processing guidelines.
  • Serves as a resource to departmental and organizational staff which includes internal departments and affiliated health networks, regarding authorization rules and processes.
  • Manages the day-to-day activities of the department to ensure compliance with company policies and regulatory requirements.
  • Attends all LTSS required meetings, Concurrent Review and Case Management clinical rounds and other meetings, including internal and external interdisciplinary care team meetings as needed or assigned.
  • Makes staffing assignments and recommendations based on authorization priority, overall workload and staffing needs per program to ensure daily workloads are fulfilled with a cost-effective use of resources and time.
  • Provides on-going/periodic in-service training for all staff based on audit findings and facilitates the on-going development and education of staff.
  • Trains, evaluates and provides performance feedback to staff as needed, including day-to-day coaching and performance feedback to individuals, annual and 90-day appraisals and Performance Improvement Plans based on individual needs; involves Human Resources as necessary.
  • Establishes and maintains effective working relationships with public and private agencies providing long term support services to members, including assisting health networks and other departments to minimize barriers to discharge planning.
  Resolves provider/vendor/member problems related to the delivery of LTSS.
  
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• 15% - Program Support
  • Conducts audits as assigned by LTSS management team as required by policy and procedure, including auditing for quantity and quality of work completed and timeliness required by regulations.
  • Provides assistance in the development and implementation of policies and procedures, as well as orientation.
  • Identifies areas of improvement in workflows, assists in the creation of desktop procedures and new workflows for corrective action and educates the LTSS staff on new/revised workflow processes.
  • Assists the Manager of LTSS in all areas of the department to ensure departmental and organizational goals are met, including the requirement to be able to complete authorization approvals for CBAS, LTC, ECM and CS programs.
  Works with the Information Technology Services (ITS) and reporting departments to support the department in the creation of reports that ensures monitoring and reporting of LTSS program activities to regulatory agencies as required by the organization and regulatory entities.
  
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• 5% - Completes other projects and duties as assigned.

Minimum Qualifications:

• Bachelor's degree in a healthcare related field required.
  
• Current unrestricted Registered Nurse (RN) License to practice in the State of California required.
  
• For non-RNs, a master's degree in healthcare, social work or related field required.
  
• 3 years of experience in applying Managed Care, Medicare, and Medi-Cal guidelines to skilled nursing facilities, CBAS, or CalAIM. Experience working with Long Term Care, Health Facilities, Managed Care, Geriatrics, or persons with disabilities required.
  
• An equivalent combination of education and experience sufficient to successfully perform the essential duties of the position such as those listed above may also be qualifying.
  
• Valid driver's license and vehicle or other approved means of transportation, an acceptable driving record and current auto insurance will be required for work away from the primary office 25% of the time or more required.

Preferred Qualifications:

• 1 year of supervisory and/or lead experience.

Required Licensure / Certifications:

• N/A

Knowledge & Abilities:

• Develop rapport and establish and maintain effective working relationships with CalOptima Health's leadership and staff and external contacts at all levels and with diverse backgrounds.
• Work independently and exercise sound judgment.
• Communicate clearly and concisely, both orally and in writing.
• Work a flexible schedule; available to participate in evening and weekend events.
• Organize, be analytical, problem-solve and possess project management skills.
• Work in a fast-paced environment and in an efficient manner.
• Manage multiple projects and identify opportunities for internal and external collaboration.
• Motivate and lead multi-program teams and external committees/coalitions.
• Utilize computer and appropriate software (e.g., Microsoft Office: Word, Outlook, Excel, PowerPoint) and job specific applications/systems to produce correspondence, charts, spreadsheets, and/or other information applicable to the position assignment.

Physical Requirements (With or Without Accommodations):

• Ability to visually read information from computer screens, forms and other printed materials and information.
• Ability to speak (enunciate) clearly in conversation and general communication.
• Hearing ability for verbal communication/conversation/responses via telephone, telephone systems, and face-to-face interactions.
• Manual dexterity for typing, writing, standing and reaching, flexibility, body movement for bending, crouching, walking, kneeling and prolonged sitting.
• Lifting and moving objects, patients and/or equipment 10 to 25 pounds

Work Environment:

If located at the 500, 505 Building or a remote work location:

• Work is typically indoors and sedentary and is subject to schedule changes and/or variable work hours, with travel as needed.
• There are no harmful environmental conditions present for this job.
• The noise level in this work environment is usually moderate.

If located at PACE:

• Work is typically indoors in a clinical setting serving the frail and elderly.
• There may be harmful or hazardous environmental conditions present for this job.
• The noise level in this work environment is usually moderate to loud.

If located in the Community:

• Work is typically indoors and sedentary and is subject to schedule changes and/or variable work hours, with travel as needed.
• Employee will occasionally work outdoors in varied temperatures.
• There may be harmful or hazardous environmental conditions present for this job.
• The noise level in this work environment is usually moderate to loud.

About CalOptima Health:
CalOptima Health is the single largest health plan in Orange County, serving one in four residents. Our motto - "Better. Together." - is at the heart of our mission to serve members with excellence, dignity and respect. We are a public agency made up of compassionate leaders and professionals working together to strengthen our community's health. We are continuing to build a culture that promotes diversity and inclusion within our community where employees have a sense of belonging, and are valued for their ideas, contributions, and their unique individual perspectives they bring. CalOptima Health has been recognized as one of Orange County's best places to work, so we know there is something special about our organization. It is why people choose to work here and why they choose to stay!

About our Benefits & Wellness options:
At CalOptima Health, we know that a healthy and happy workforce is a thriving workforce, which is why we offer a comprehensive benefits package, including participation in the California Public Employees Retirement System (CalPERS), low-cost medical/vision/dental insurance options, and paid time off. To support quality work-life balance, we allow flexible scheduling during core business hours, telework options for some positions, work schedules that allow every other Monday or Friday off (9/80 schedule), and a wellness program featuring diverse activities. Additionally, CalOptima Health contributes 4% of pensionable earnings to a 401(a) retirement program with no required employee contribution. For those who are interested in additional retirement savings, employees have access to 457(b) retirement plans with pre/post-tax contribution options. For more information, please click on the 2024 CalOptima Health Benefits Guide regarding our comprehensive benefits and wellness package.

IMPORTANT APPLICATION INFORMATION AND INSTRUCTIONS

Applications will be accepted on a continuous basis until a sufficient number of qualified applications have been received. The deadline for the first review of applications is May 6, 2024 at 9:00 PM (PST). Applicants are encouraged to apply early. Applicants that apply after the first review are not guaranteed to be considered for this recruitment. This recruitment may close at any time without notice after the first review date.

The selection process may include, but is not limited to, a skills assessment, phone screen and interview.

The successful candidate will be required to undergo a reference / background check (to include a conviction record) and if applicable also pass a post-offer pre-employment medical examination (which will include a drug screening). Internal CalOptima Health applicants should apply through InfoNet.

Communication regarding your application will be sent to the email address listed on your application. Please check your email, including your SPAM folder, regularly throughout the recruitment process. You can also visit your candidate portal to receive the most up to date status of your application.

CalOptima Health is committed to attracting, hiring, and retaining a diverse staff, where we will honor your unique experiences, identity, and perspectives. Our organization strives to create and maintain a workplace environment that is inclusive, equitable and welcoming so we can truly be Better Together.

CalOptima Health is an equal opportunity employer and makes all employment decisions on the basis of merit. CalOptima Health wants to have qualified employees in every job position. CalOptima Health prohibits unlawful discrimination against any employee, or applicant for employment, based on race, religion/religious creed, color, national origin, ancestry, mental or physical disability, medical condition, genetic information, marital status, sex, sex stereotype, gender, gender identity, gender expression, transitioning status, age, sexual orientation, immigration status, military status as a disabled veteran, or veteran of the Vietnam era, or any other consideration made unlawful by federal, state, or local laws. CalOptima Health also prohibits unlawful discrimination based on the perception that anyone has any of those characteristics or is associated with a person who has, or is perceived as having, any of those characteristics.

If you are a qualified individual with a disability or a disabled veteran, you may request a reasonable accommodation at (714) 246-8400 if you are unable or limited in your ability to access job openings or apply for a job on this site as a result of your disability.

To apply, please visit: https://jobs.caloptima.org/jobs/supervisor-long-term-support-services-505-city-parkway-california-united-states

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