Supervisor Health Plan Operations - USFHP

About the role

Organizes and directs the daily activities and department workflow of the Referrals and Referral Support Staff under the supervision of the Director of USFHP Operations. Providence caregivers are not simply valued – they’re invaluable. Join our team at Pacmed Clinics DBA Pacific Medical Centers and thrive in our culture of patient-focused, whole-person care built on understanding, commitment, and mutual respect. Your voice matters here, because we know that to inspire and retain the best people, we must empower them.

Responsibilities

• Ensure accurate and timely data entry and processing of authorization and referrals of Pacific Medical Centers' revenues and expenses for Outside e (OPS).
• Assure compliance with DoD and other government agency guidelines and contract requirements.
• Set Referral policy and monitor compliance.
• Monitor Medicare and TRICARE referral guidelines and educate staff on changes.
• Identify and solve processing issues with outside providers.
• Serve as a member of the US Family Health Plan management team.
• Jointly manage the US Family Health Plan budget with the Director of USFHP Operations and other members of the management team.

Requirements

• 4 years of health care referrals experience.
• 2 years of experience in a supervisory capacity, including a Lead role, or 6 months of supervisory experience within a health plan.

Qualifications

• Bachelor's degree in Health Care Administration or Business Administration (preferred).

Benefits

• Best-in-class benefits designed to support you and your family in staying well, growing professionally, and achieving financial security.
• Retirement 401(k) Savings Plan with employer matching.
• Health care benefits (medical, dental, vision).
• Life insurance.
• Disability insurance.
• Time off benefits (paid parental leave, vacations, holidays