CenCal Health is a publicly-funded managed care organization that provides health care coverage for residents in Santa Barbara and San Luis Obispo counties. We are currently seeking a Claims Customer Service Supervisor in our Santa Barbara office location.

We're looking for a RN that likes to make visits to local providers/clinics to upgrade our quality of care for our members. Need to have 2+ years experience in healthcare field, outpatient care a plus. Are you good at understanding clinical issues and medical diagnosis? Performed chart audits? We've got an opportunity for you!

This role has a requirement of being in office 1 day per month in Santa Barbara

Strong team-oriented ability to
connect with quality improvement staff, and establish and maintain positive
professional working relationships, both within and outside CenCal Health
Knowledge of quality improvement
theory, strategy, and practical methods to achieve rapid-cycle improvement;
Ability to perform effectively under
pressure and maintain focus on daily responsibilities for long-term projects;
Ability to establish and nurture
positive professional working relationships with CenCal Health customers;
Ability to evaluate data,
establish facts and draw valid conclusions;
Effective oral and written
communication skills;
Ability to perform HEDIS medical

Education and Experience

Bachelor’s Degree in ajob-related field
2 years’ experience in a managed care quality management setting (or combination of academic, professional or work experience that demonstrates ability to perform the duties of the position.
Current and unrestricted Registered Nurse (RN) license to practice in California

DESIRED:

A graduate degree in a
healthcare- or management-related discipline is preferred (e.g., MBA, MPH)
Certified Professional in
Healthcare Quality (CPHQ) or similar certification
HEDIS medical record data abstraction

An emphasis in Medicaid/Medi-Cal managed care

Salary Range: $78,562 - $121,771

To view our current job openings, please visit our website at www.cencalhealh.org.

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