Pre-Enrollment RN Supervisor
Tasks
- Author clinical summaries for Medical Director communication
- Catch documentation discrepancies and manage resubmissions
- Collaborate with Intake Data Ops and Clinical Operations to resolve workflow gaps
- Coordinate ILOC email workflows and submission sequencing
- Coordinate schedules and home visit assignments
- Deliver training to Enrollment RNs
- Enforce ILOC turnaround standards
- Enforce Pre Enrollment SOPs across sites
- Ensure H and S determinations comply with federal requirements
- Ensure case status updates across Epic Salesforce and tracker
- Escalate at risk cases with mitigation recommendations
- Identify no show trends and recommend adjustments
- Identify stalled cases and return cases with next steps
- Maintain Epic audit trails
- Maintain enrollment operations during leadership absences
- Maintain training logs and competency documentation
- Monitor enrollment home visit activity and rescheduling
- Own daily review of RN tracker and enrollment pipeline
- Participate in PACE audits by DHCS and CMS
- Provide day to day enrollment case support
- Receive and triage level 2 case flags and confirm escalation criteria
- Review ILOC submissions before DHCS submission
- Run Health and Safety committee operations including packet assembly and facilitation
- Track enrollment readiness categories and cutoff risk
- Track visit capacity to anticipate bottlenecks
Perks/Benefits
- N/A
Skills/Tech-stack
CRM | Care Coordination | Case management | Clinical Documentation | DHCS | Electronic Health Records | Epic | HIPAA | Health Records | ILOC | Infection control | Microsoft Excel | Microsoft Outlook | Microsoft Word | PPE | Pace | Regulatory Compliance | Salesforce | Workflow Management
Education
Roles
Related jobs
-
CDIP | CDIS | Clinical Documentation | Clinical Documentation Integrity | DRGHealthcare job license required | Remote work | Residency in KY or IN requiredMid-level Full TimeKentucky - Work from Home, United … R10d ago
-
Provider Enrollment Supervisor - Remote US USD 51K-74KAudit review | Customer Service | Data Integrity | Fraud Prevention | Healthcare Compliance401k employer match | Comprehensive health benefits | Educational assistance | Flexible vacation policy | Leadership development programsMid-level Full TimeAny city, NJ, US, 99999 R18d ago
-
Credentialing and Enrollment Supervisor USD 78K-90KCross-Functional Collaboration | Cross-functional | Data Analysis | Delegated Credentialing | Functional collaboration401k matching | Employee wellness program | Free therapy | Hardware and software allowance | Health, dental, vision coverageMid-level Full TimeUS - Remote R20d ago
-
Supervisor - Data Services -- Remote USD 87K-160KAccess Control | Alerting | Business Intelligence | Cause analysis | Data Engineering401k match | Company-provided equipment | Employee assistance program | Employee resource groups | Paid HolidaysSenior-level Full TimeLittle Rock, Arkansas, United States; Remote, … R25d ago