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Managed Care Liaison Supervisor, PIH Health - Home Health & Hospice, La Mirada, Full Time, Days

Apply Now Hospital Name PIH Health Whittier Hospital Location La Mirada, California Job Type Full-Time/Regular Job ID 15779-977 Date posted 04/18/2022

PIH Health is a nonprofit, regional healthcare network that serves approximately 3 million residents in the Los Angeles County, Orange County and San Gabriel Valley region. The fully integrated network is comprised of PIH Health Hospital - Whittier, PIH Health Hospital - Downey and PIH Health Good Samaritan Hospital, 27 outpatient medical locations, a multi-specialty medical (physician) group, home healthcare services and hospice care, as well as heart, cancer, women’s health, urgent care and emergency services.

Oversees the daily activities of Managed Care Liaisons (MCLs) in the managed care operations of Home Health and Hospice. This position coordinates a team of RNs and LVNs who process referrals, authorizations, billing, quality assurance and utilization review and capitation for hospital services. Performs comprehensive review of the Outcome and Assessment Information Set (OASIS), Home Health Plan of Care and Strategic Healthcare Program (SHP) as required. Performs Utilization review as required on active and discharged patients. Supervisor reports to the Director of Finance. Collaborates with the Clinical team for Home Health and Hospice


Required Skills

Required:

  • California Registered Nurse License
  • Bachelor of Science in Nursing
  • Driver’s License
  • Valid auto insurance
  • Previous experience in Home Health or Hospice
  • Experience with OASIS Assessments, all related documentation and regulatory standards for documentation.
  • Knowledge of Title 22 and Medicare Coverage Manual
  • Able to demonstrate broad knowledge of third party insurance, Managed Care, Medicare, Medi-cal, Medicare advantage, HMO, and PPO regulations governing home health and hospice.
  • Experience in Quality Assurance and Utilization review. 

Preferred:

  • Master of Science in Nursing
  • Certified Managed Care Nurse (CMCN)

The organization is recognized by Watson Health as one of the nation’s Top Hospitals, and College of Healthcare Information Management Executives (CHIME) as one of the nation’s top hospital systems for best practices, cutting-edge advancements, quality of care and healthcare technology. PIH Health is certified as a Great Place to Work TM. For more information, visit PIHHealth.org or follow us on FacebookTwitter, or Instagram.

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Recruitment Fraud Alert

PIH Health is aware of a scam involving cybercriminals using the PIH Health logo and likeness in fake job posting. PIH Health will never request banking information, or any other financial information from job candidates. If you are suspicious of a PIH Health job postings on any online recruitment site please contact the PIH Health Human Resources Department at 562.698.0811, Ext. 12483 to verify the legitimacy of the job posting. You can also file a report with the FBI’s Internet Crime Complaint Center at IC3.gov.