Supervisor Health Plan Operations - USFHP

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.  Responsibilities include ensuring accurate and timely  data entry and processing of authorization and referrals of Pacific Medical Centers' revenues and expenses for Outside e (OPS),.  Assures compliance with DoD and other government agency guidelines and contract requirements.  Sets Referral policy and monitors compliance to same.  Monitors Medicare and TRICARE  referral guidelines and educates staff in changes.  Identifies and solves processing issues with outside providers.  Serves as a member of the US Family Health Plan management team.  Jointly manages the US Family Health Plan budget with the Director of USFHP Operations and the other members of the management team.

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.

Required Qualifications:

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

Preferred Qualifications:

• Bachelor's degree in Health Care Administration or Business Administration

Why Join Providence? 

Our best-in-class benefits are uniquely designed to support you and your family in staying well, growing professionally, and achieving financial security.  We take care of you, so you can focus on delivering our mission to advocate, educate and provide extraordinary care.

Accepting a new position at another facility that is part of the Providence family of organizations may change your current benefits. Changes in benefits, including paid time-off, happen for various reasons. These reasons can include changes of Legal Employer, FTE, Union, location, time-off plan policies, availability of health and welfare benefit plan offerings, and other various reasons.