Senior Case Management Supervisor

Santa Clara Family Health Plan; San Jose (CA); On-site; USD 114,000 - 176,000; Full time

Job summary

Santa Clara Family Health Plan is seeking a Supervisor of Case Management in San Jose, CA. The role oversees daily case management operations, supervises Case Managers and Personal Care Coordinators, and ensures compliance with state and federal regulations.

Responsibilities include developing programs and workflows, coordinating referrals across lines of business, and partnering with internal departments to optimize member care and program performance. Exempt position with a competitive salary.

Qualifications

• Unrestricted professional clinical licensure in California (R).
• Minimum two years supervisory or lead experience in case management in a managed care setting (R).
• Current working knowledge of Medicare and/or MediCal regulations and NCQA Population Health standards (R).
• CMSA Certification in Case Management (D).
• Maintenance of a valid California driver's license to travel to offsite meetings or events (R).
• Bi-lingual in Spanish, Vietnamese, Chinese or Tagalog preferred (D).
• Ability to efficiently operate computer software including Outlook, Word, Excel, and case management programs. (R)
• Excellent communication skills and the ability to interact clearly with staff, members, providers, and partners. (R)

Responsibilities

• Develop, implement and supervise case management workflows in compliance with state and federal requirements.
• Monitor quality improvement of case management processes and documentation.
• Collaborate with the Manager of Case Management on audits and corrective action plans.
• Ensure integration of Case Management with Long Term Services and Supports and Behavioral Health.
• Oversee RN Case Manager, Medical Management Coordinator and Personal Care Coordinator caseloads.
• Resolve complex issues by escalating to management as needed.
• Foster effective relationships with staff, members, providers and external stakeholders.
• Attend offsite meetings or events as necessary.
• Perform other related duties as required.

Skills

Communication skills

Attention to detail

Time management

Bilingual: Spanish/Vietnamese/Chinese/

Tools

Outlook

Word

Excel

Case management software

Job description

Santa Clara Family Health Plan is seeking a Supervisor of Case Management in San Jose, CA. The role oversees daily case management operations, supervises Case Managers and Personal Care Coordinators, and ensures compliance with state and federal regulations.

Responsibilities include developing programs and workflows, coordinating referrals across lines of business, and partnering with internal departments to optimize member care and program performance. Exempt position with a competitive salary.