Nurse Supervisor, Post Acute Care
San Francisco Health Plan
San Francisco Health Plan (SFHP) is seeking a Nurse Supervisor to manage a team of Post-Acute Care nurses. The candidate must be a CA licensed registered nurse who is passionate about making a difference in the lives of individual members and improving our healthcare system in San Francisco. You are responsible for building and maintaining a high performing team of nurses committed to providing exemplary service and ensuring the delivery of high-quality care. Candidates should be a skilled team player, detail oriented, innovative and committed to the belief that utilization management and facilitating transitions to the appropriate level of care are key to maintaining sustainability of our safety net health systems.
Work Schedule: Monday – Friday
This is a hybrid position with occasional in-office requirement.
WHAT YOU WILL DO:
- Supervise Post-Acute Nurses
- Train, coach, and assist in hiring Post-Acute Nurses
- Maintain Post-Acute Nurse Schedule
- Work collaboratively with the Post-Acute, CCR and Prior Authorization Nurses, UM Coordinators, all Health Services staff, Managers and Medical Directors.
- Plan and organize daily operational work to ensure operational efficiency and effectiveness of the department.
- Research and trouble-shoot issues at the lowest level prior to escalating.
- Provide assistance to team to resolve issues. Ensure that staff are handling provider inquiries properly and effectively, and promptly following up on unresolved issues.
- Participate in provider led rounds and case conferences as needed on complex placements and all Post-Acute process dialogues
- Provide guidance to hospital and post-acute staff on appropriate resources available to members to achieve the optimal functioning and stability in the post-acute setting Creates, maintains and trends performance and utilization reports.
- Continuously improves the managed care process and pipeline of new opportunities for Post-Acute Care.
- Oversees quality initiatives and metrics for the Post-Acute team
- Ensures appropriate documentation of Post-Acute processes and procedures
- Ensures the privacy and security of PHI (Protected Health Information) as outlined in SFHP’s policies and procedures relating to HIPAA compliance.
- Performs Post-Acute processes including placement workflows, clinical reviews, authorization assessments and NOA correspondence approximately 30% of the time, as applicable
WHAT YOU WILL BRING:
- A valid unrestricted Registered Nurse license in the state of California
- A Bachelor’s degree in business or a health care related field, or equivalent work experience
- 2-5 years of acute clinical experience in a hospital required.
- At least 2 years of managed care experience in case management, resource management or utilization review preferred.
- 2-4 years of supervisory experience strongly preferred.
- Knowledge of San Francisco County community resources and Medi-Cal is helpful but not required
- Strong critical thinking skills including the ability to recognize social and medical risk factors and chronic disease conditions
- Ability to work with socially and ethnically diverse populations.
- Knowledge of state and federal insurance programs preferred.
- Experience with Medi-Cal, NCQA, DHCS and DMHC regulations and standards preferred.
- Medical Plans: You’ll have a choice of medical plans, including options from Kaiser and Blue Shield of California. Employee-only coverage in the HMO plans are currently available at no cost and dependent coverage is heavily subsidized by SFHP.
- Dental: You’ll have a choice of a basic dental plan or an enhanced dental plan which includes orthodontic coverage.
- Vision: Employee vision care coverage is available at no cost.
- Time Off: 23 days of Paid Time Off and 12 observed company holidays.
- Professional development: Opportunities for tuition reimbursement, professional license/membership.
Established in 1994, San Francisco Health Plan (SFHP) is an award winning, managed care health plan whose mission is to provide affordable health care coverage to the underserved low and moderate-income residents in San Francisco county. SFHP is chosen by eight out of every ten San Francisco Medi-Cal managed care enrollees and its 170,000+ members have access to a full spectrum of medical services including preventive care, specialty care, hospitalization, prescription drugs, and family planning services. SFHP was designed by and for the residents it serves, and takes great pride in its ability to accommodate a diverse population that includes young adults, seniors, and people with disabilities.
San Francisco Health Plan is proud to be an equal opportunity employer. We are committed to a work environment that supports, inspires, and respects all individuals and in which our people processes are applied without discrimination on the basis of race, color, religion, sex, sexual orientation, gender identity, marital status, age, disability, national or ethnic origin, military service status, citizenship, or other protected characteristics.
Pursuant to the San Francisco Fair Chance Ordinance, we will consider for employment qualified applicants with arrest and conviction records.
San Francisco Health Plan is an E-Verify participating employer.
Hiring priority will be given to candidates residing in the San Francisco Bay Area and California.