STARPLUS Long Term Services and Support Utilization Mgmt Supr El Paso Health
STARPLUS Long Term Services and Support Utilization Mgmt Supr El Paso Health
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1 Vacancy
Job Description
Job Summary
Responsible for overseeing the daily operations of the Long Term Services and Support (LTSS) authorization and referral process to ensure compliance with Texas Health and Human Services Commission (HHSC) regulations and program guidelines. Supports the departments leadership in assessing planning developing implementing and evaluating a comprehensive LTSS authorization strategy that aligns with El Paso Healths (EPH) mission and vision. Responsible for optimizing department workflows policies and procedures mentoring and training Associates fostering effective communication across internal departments and ensuring the department operates efficiently and effectively. Ensures Associates meet performance goals resolves member and provider issues and maintains high levels of customer service satisfaction.
Skills
1. Possesses strong leadership organizational and communication skills to ensure the STARPLUS LTSS authorization and referral processes operate seamlessly and in compliance with all regulatory requirements.
2. Ability to supervise plan and implement processes; organize documentation of activities to report and continuously evaluate progress. Maintains efficient operations through customer service and performance improvement tools.
3. Knowledge of federal state andCMS and regulatory accrediting agency standards to assure compliance.
4. Ability to communicate effectively with strong written and verbal skills.
5. Ability to understand use and teach the principles of customer service and performance improvement.
6. Ability to evaluate customer service issues and present data to other professionals in a clear concise manner.
7. Ability to proficiently utilize analytical assessment and creative problem solving.
8. Ability to use critical thinking skills to conduct research and utilize interpersonal and problemsolving skills.
9. Ability to organize delegate implement and evaluate effectiveness of processes.
10. Ability to interview and work in teams.
11. Ability to prioritize organizational performance improvement efforts.
12. Knowledge of report writing software and working with Microsoft Office.
13. Knowledge of health plan systems and organizational relationships.
14. Knowledge of customer service and performance improvement methodologies to address performance improvement processes.
15. Knowledge of a wide range of concepts principles and practices in the managed care profession.
16. Knowledge of healthcare trends and proven solutions for improving customer service.
17. Bilingual (English and Spanish) highly preferred.
Work Experience
One year of supervisory/lead experience is required. Strong background in LongTerm Services and Support (LTSS) authorization and referral services customer service health plan operations and a keen understanding of the managed care market and health care delivery system.
License/Registration/Certification
Completion of the OnDemand LTSS Authorization Technician certificationis required within one year of being in the position.
Education and Training
Highschool diploma or equivalent is required. Bachelor degree in Business Healthcare Administration or Public Health is preferred.
Employment Type
Full-Time
