Supervisor, Transitional Care Services

Salary Range:  $102,183.00 (Min.) - $132,838.00 (Mid.) - $163,492.00 (Max.)

Established in 1997, L.A. Care Health Plan is an independent public agency created by the state of California to provide health coverage to low-income Los Angeles County residents. We are the nation’s largest publicly operated health plan. Serving more than 2 million members, we make sure our members get the right care at the right place at the right time.

Mission: L.A. Care’s mission is to provide access to quality health care for Los Angeles County's vulnerable and low-income communities and residents and to support the safety net required to achieve that purpose.

Job Summary

The Supervisor of Transitional Care Services (TCS) is responsible for supervising the TCS clinical and non-clinical staff’s daily work and activities. The Supervisor ensures adequate staffing and coverage adherence to Department of Health Care Services (DHCS) TCS program and documentation requirements, and that eligible members receive timely and quality services.

This position is responsible for promoting the optimal clinical outcomes and improving quality of care through clinical priorities for members.  This position utilizes independent clinical judgment to promote quality of care through collaboration with cross-functional teams at L.A. Care (LAC). The position assist in identifying and triaging member and operational issues/problems, and forming resolutions within the scope of work.

The position provides ongoing program support through active communication, education, and consultation of interdisciplinary staff.  The position supervises all aspects of running an efficient team, including hiring, supervising, coaching, training, disciplining, and motivating direct-reports, 

This position is responsible for ensuring all functions are operating in accordance with the organization's mission, values and strategic goals. 

Duties

Supervise staff , including, but not limited to: monitoring of day to day activities of staff, monitoring of staff performance, mentoring, training, and cross-training of staff, handling of questions or issues, etc. raised by staff, encourage staff to provide recommendations for relevant process and systems enhancements, among others.

Consult with management and Human Resources Business Partner (HRBP) to review performance improvement plans prior to meeting with staff.

Assist in developing written policies and procedures and practice protocols pertinent to the transitional care and regulatory program requirements. Plan and direct TCS activities to provide timely, quality care and services to members experiencing a care transition. Recommend process improvement measures to achieve program’s performance measures outcomes and goals.

Conduct and coordinate analysis of data to track and trend for the purpose of improving programmatic and performance on issues related to safe transitions, readmission reduction, and other programs as determined.  .  Monitor the progress of programs or services in relation to expected standards across the continuum of care.  Benchmark best practices and identify measurable outcomes.  Recommend innovative approaches to patient care. Collect, analyze, and communicate data related to transitions of care and other related metrics.

Conduct monthly audit activity via program’s performance reporting standards to maintain quality care of members and compliance to regulatory requirements. Collect and organize team performance data to identify trends and maintains all assigned reporting responsibilities. Ensure the accuracy of TCS reports and program proficiency in maintaining regulatory standards and schedules. Provide reports to management to identify trends and improve workflow process.

Duties Continued

Provide clinical leadership for Transitional Care and other related program goals. Consult with cross-functional teams concerning patient care issues Coordinate quality improvement activities in transitions of care as demonstrated through identifying clinical priorities and outcomes (e.g. HEDIS, etc.).  

Assist in the development and implementation of communication strategies to keep internal and external stakeholders informed of Transitional Care initiatives.

Ensure program compliance with Health Insurance Portability and Accountability Act (HIPAA) regulations relating to protection of personal history information (PHI).

Maintains knowledge of current trends and practices in Transitional Care, nursing, and health care through networking and other resources. Enhance professional and unit growth through active participation in professional organizations, department activities, and community groups.

Perform other duties as assigned.

Education Required

Associate's Degree in Nursing or Related FieldMaster's Degree in Social Work or Related Field

Education Preferred

Bachelor's Degree in Nursing

Experience

Required:

Minimum of 5 years of recent care management, care coordination, and/or transition of care experience in a hospital or managed care setting, such as a health insurance environment and/or experience as care manager in hospital or home health environments.

At least 2 years of leading a process, program or staff or supervisory/management experience.

Equivalency: Completion of the L.A. Care Management Certificate Training Program may substitute for the supervisory/management experience requirement.

Skills

Required:

Knowledge of state, federal and regulatory requirements in care/disease management, care coordination, population health management, health education and Transitional Care Services.

Excellent interpersonal communication, problem solving, and conflict resolution skills.

Knowledge of complex health care systems and proficiency in performing medical record reviews.

Knowledge of professional nursing practice elements and evidence-based models of transitional care.

Computer literacy with proficiency with Microsoft Word, Excel, and core program systems.

Excellent organizational and time management skills.

Must be detailed oriented and an enthusiastic team player.

Ability to work independently and with internal and external customers.

Ability to solve complex issues, identify, and implement creative solutions.

Preferred:

Bilingual in one of L.A. Care Health Plan’s threshold languages is highly desirable. English, Spanish, Chinese, Armenian, Arabic, Farsi, Khmer, Korean, Russian, Tagalog, Vietnamese  

Licenses/Certifications Required

Registered Nurse (RN) - Active, current and unrestricted California LicenseLicensed Clinical Social Worker (LCSW) - Active, current and unrestricted California License

Licenses/Certifications Preferred

Certified Case Manager (CCM)

Required Training

Physical Requirements

Light

Additional Information

Please note that a Licensed Clinical Social Worker is only required when Master's Degree in Social Work. Licensed Clinical Social Worker not required with Associate's or Bachelor's Degree in Nursing.

Able to work flexible job hours.

Salary Range Disclaimer: The expected pay range is based on many factors such as geography, experience, education, and the market.  The range is subject to change.

L.A. Care offers a wide range of benefits including

• Paid Time Off (PTO)
• Tuition Reimbursement
• Retirement Plans
• Medical, Dental and Vision
• Wellness Program
• Volunteer Time Off (VTO)

Nearest Major Market: Los Angeles
Job Segment: Social Worker, Nursing, Registered Nurse, Patient Care, Service, Healthcare