Overview

Supervisor, Referral Services Jobs in Austin at Superior HealthPlan


Title: Supervisor, Referral Services

Company: Superior HealthPlan

Location: Austin

You could be the one who changes everything for our 25 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, multi-national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility.

Position Purpose:

Supervise the day to day operations of the utilization and case management areas

Supervise day to day activities of the Referral Services department including work flow, training, hiring, etc.

Assist providers, members and/or internal customers with cases pertaining to referral questions, issues and authorizations

Reconcile pended claim issues in a timely manner per health plan/department procedure

Review and process denial letters, maintain logs, and coordinate decisions to external or internal personnel per plan procedures

Receive and review incoming phone and case management log reports and determine course of action

Work with analysts and programmers in adapting and testing programs and procedures to adhere to our standard operating procedures

Our Comprehensive Benefits Package:

Flexible work solutions including remote options, hybrid work schedules and dress flexibility

Competitive pay

Paid Time Off including paid holidays

Health insurance coverage for you and dependents

401(k) and stock purchase plans

Tuition reimbursement and best-in-class training and development

Education/Experience:

High school diploma or equivalent. 3+ years of prior authorization, physician’s office, customer service, claims processing or provider relations experience preferably in a managed care setting. Previous experience as a lead in a functional area or managing cross functional teams on large scale projects.

Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.

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About Superior HealthPlan