Diagnostic Referral Supervisor (Remote) 2023- 1265

Nashville, TN, USA
NPN Operations
Full Time

Diagnostic Referral Supervisor Remote Nationwide

Overview

Are you interested in empowering and sustaining healthy, positive, and measurable differences in the health of individuals while leading a team? Does the thought of leading and motivating a team of exceptionally talented case managers inspire you? Do you thrive in shaping and organizing teams to provide high-quality care that affects individual lives? We believe it takes teamwork and organization to provide medical and care experts to help those with chronic acute conditions to live their best life, teamwork led by a highly skilled home-based Diagnostic Referral Management Supervisor.

Your broad responsibilities will include overseeing medical service delivery and the management of diagnostic services to dedicated accounts while ensuring the delivery meets high-quality, efficient, and cost-effective standards in accordance with the World Trade Center Health Program guidelines. Ideal candidates will possess both a nursing leadership background that enables them to supervise, coach, and easily interact with medical care coordinators, as well as a professional background that enables them to easily interact and establish deep professional relationships with team members and program medical directors

Diagnostic Referral Supervisor Responsibilities: Work independently in your home office setting.
Provide direct supervision to medical care coordinators in the application of corporate policies and procedures, protocols, timesheets, PTO, and expense review and approval.
Oversee, and modify as-needed, diagnostic referrals to network providers and ensure timely, effective, and efficient services to beneficiaries.
Review medical and administrative documentation for accuracy and, if needed, seek additional documentation prior to forwarding reports to the Medical Directors.
Facilitate workflows in collaboration with clinical teams to optimize interdepartmental coordination and efficiency.
Collaborate with Program Pharmacists in order to ensure Program pharmacy benefits are activated as required for diagnostic evaluations
Collaborate with internal partners, such as Claims, Pharmacy, Medical Case Management, Quality Management, Member Services, Analytics, and Information Technology, to meet beneficiaries' needs and bring creative solutions to meet corporate goals and achieve client requirements.
Collaborate with external stakeholders and clients to ensure contract requirements and program diagnostic services are successfully carried out.
Provides input to Program Medical Directors and teams regarding analysis, updates, and recommendations for modifications for procedures and processes to continually improve operations and protocols.
Understands each contract's clinical quality assurance requirements and monitors compliance, in collaboration with the MCA analytics and management teams.
Provides feedback and coordination of improvement of quality tools, such as audit checklists and instructions.
Effectively counsel and coach employees on performance and behavioral improvements. Understand and appropriately apply employee disciplinary procedures.
Diagnostic Referral Supervisor Qualifications Bachelor's degree in healthcare, Master's or Doctorate degree in Nursing or Physician Associate studies
An active unrestricted license as an Advanced Practitioner (Physician Assistant or Nurse Practitioner) in a state or territory of the United States is required.
At least 5 years of clinical practice experience as a nurse or licensed health care professional.
At least 2 years of experience as a team lead or above.
Experience in Occupational Medicine, Internal Medicine, Family Medicine, or inpatient medicine is preferred.
Experience with government regulations.
Nationally recognized Quality-related professional certification such as Certified Professional Healthcare Quality or Six Sigma (preferred).
Experience with government regulations.
Demonstrated ability to work independently and along with others
Attention to detail, timetables, and commitment to completing tasks
Experience with Microsoft Windows and computer savvy
Must be well organized, efficient, and able to prioritize competing priorities and make sound judgments
Ability to define, and resolve problems and challenges in a workplace setting
Responsible for having reliable High-Speed Cable or Fiber Optic Internet service
Provide leadership and assistance to colleagues in daily operations. Motivate and manage colleagues to ensure performance standards are met or exceeded.
Provide timely direct feedback to staff through scheduled guidance/coaching sessions and annual evaluations. This includes active coaching and engaging colleagues to enhance their performance and commitment. Assist colleagues to develop skills as needed to achieve optimal performance in their roles.
U.S. Citizenship
Prior to hiring and training must be able to pass a preliminary credit and background check
In addition to a competitive salary, comprehensive health and welfare benefits, tuition reimbursement, and incentive compensation, Sedgwick Government Solutions offers participation and vesting in a 401(k) plan with a company match and tuition assistance. If you would like to contribute to our important mission and work collegially in a professional organization that values intelligence, integrity, and initiative, consider a career with Sedgwick Government Solutions.

To be considered for this position, please submit a resume, and complete the application.

The information provided above has been designed to indicate the general nature and level of work of the position. It is not a comprehensive inventory of all duties, responsibilities, and qualifications required.

Important Information

Successful candidates will be required to undergo a financial and criminal background check and obtain and maintain confidential-level security clearance upon hire. We participate in the United States Federal Government E-Verify program to confirm the employment authorization of the employee upon hire.

Search Firm Representatives

Please be advised that Sedgwick Government Solutions (Government Solutions) is not seeking assistance or accepting unsolicited resumes from search firms for this employment opportunity. Regardless of past practice, a valid written agreement and task order must be in place before any resumes are submitted to Government Solutions. All resumes submitted by search firms to any employee at Government Solutions without a valid written agreement and task order in place will be deemed the sole property of Government Solutions and no fee will be paid in the event that person is hired by Government Solutions.

Government Solutions strives to make our career site accessible to all users. If you need a disability-related accommodation for completing the application process, please contact Government Solutions regarding accommodations.

Sedgwick Government Solutions is an Equal Opportunity and Affirmative Action Employer

All qualified applicants will receive consideration for employment without regard to age, citizenship status, color, disability, marital status, national origin, race, religion, sex, sexual orientation, gender identity, veteran status, or any other classification protected by federal state or local laws as appropriate, or upon the protected status of the person's relatives, friends or associates.

Sedgwick Government Solutions abides by the requirements of 41 CFR 60-741.5(a) . This regulation prohibits discrimination against qualified individuals on the basis of disability and requires affirmative action by covered prime contractors and subcontractors to employ and advance in employment qualified individuals with disabilities.

Sedgwick Government Solutions abides by the requirements of 41 CFR 60-300.5(a) . This regulation prohibits discrimination against qualified protected veterans and requires affirmative action by covered prime contractors and subcontractors to employ and advance in employment qualified protected veterans.

About Sedgwick

Sedgwick Government Solutions is a fully owned subsidiary of Sedgwick. Sedgwick is a leading global provider of technology-enabled risk, benefits, and integrated business solutions. Taking care of people is at the heart of everything we do. Millions of people and organizations count on Sedgwick Government Solutions each year to take care of their needs when they face a major life event or something unexpected happens. The company provides a broad range of resources tailored to the client's specific needs in casualty, property, marine, benefits, and other lines. At Sedgwick, caring counts; through the dedication and expertise of more than 27,000 colleagues across 65 countries, the company takes care of people and organizations by mitigating and reducing risks and losses, promoting health and productivity, protecting brand reputations, and containing costs that can impact the bottom line. www.sedgwick.com

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