TRIWEST HEALTHCARE ALLIANCE CORP Supervisor, Medical Operations in New Orleans, Louisiana

Responsible for supervising the Complex Authorization Specialists for the Veterans Administration Patient-Centered Community Care (VAPCCC) programs. The Supervisor is responsible for all aspects of the complex referral and authorization, secondary authorization, medical documentation and clinical quality monitoring processes. This position will oversee day to day operations to meet applicable VAPCCC contract standards.Education and ExperienceRequired: Licensed Practical Nurse with current unrestricted license in appropriate state or territory of the United States; OR Associates Degree in a health care discipline, health care management or equivalent experienceo Two years or more of team lead or higher experience o Two years or more health care experience o Managed care or operational experience in medical management systems, including referral management/prior authorization, health care office processes or utilization managementPreferred: o Two years or more experience in a health related production or medical office environment o Knowledge of Veteran Administration Health SystemKey Responsibilitieso Supervises Complex Authorization Specialists staff to ensure VA contractual standards are met.o Serves as primary clinical resource for referral management and medical documentation reviewo Provides clinical support and interpretation assistance to non-clinical staff for both medical/surgical referrals and authorizations.o Develops and implements enhanced systems and processes to improve operational performance metrics and delivery of care.o Monitors ongoing compliance with contract standards for timeliness and quality.o Collaborates with staff for data compilation and statistical analysis.o Makes daily staffing assignments in coordination with the Contact Center SupervisorsParticipates in cross-functional teams to enhance business strategies, process improvement, and use of industry best practices.o Provides coaching, mentoring and performance evaluations for assigned reportso Performs other duties as assigned.o Regular and reliable attendance is required.CompetenciesCommunication / People Skills: Ability to influence or persuade others under positive or negative circumstances; Adapt to different styles; Listen critically; Collaborate.Computer Literacy: Ability to function in a multi-system Microsoft environment using Word, Outlook, TriWest Intranet, the Internet, and department software applications.Coping / Flexibility: Resiliency in adapting to a variety of situations and individuals while maintaining a sense of purpose and mature problem-solving approach is required.Independent Thinking / Self-Initiative: Critical thinkers with ability to focus on things which matter most to achieving outcomes; Commitment to task to produce outcomes without direction and to find necessary resources.Information Management: Ability to manage large amounts of complex information easily, communicate clearly, and draw sound conclusions.High Intensity Environment: Ability to function in a fast-paced environment with multiple activities occurring simultaneously while maintaining focus and control of workflow.Leadership: Successfully manage different styles of employees; Provide clear direction and effective coaching.Multi-Tasking / Time Management: Prioritize and manage actions to meet changing deadlines and requirements within a high volume, high stress environmentProblem Solving / Analysis: Ability to solve problems through systematic analysis of processes with sound judgment; Has a realistic understanding of relevant issues.Technical Skills: Thorough knowledge of health care delivery, managed care concepts, management reporting tools, and medical management systems; ability to perform critical, in-depth analysis of medical records for appropriateness and effectiveness of referral activities