Sr. Manager, Service Coordination

POSITION SUMMARY/RESPONSIBILITIES

Provide oversight and management of the Community First Health Plans (CFHP) STAR Kids clinical activities and deliverables related to service coordination assuring all contractual, regulatory and accreditation standards are met. Provide administrative and clinical guidance to all Population Health Management (PHM) STAR Kids clinical and administrative staff. Oversee the efficient utilization of resources within the schedule of benefits for the STAR Kids program.  Implements projects and activities to attain goals established by the Health System. Develops policies and procedures to assure compliance with Medicaid or any other agency that UHS is contractually required to follow. Promotes the Health System’s mission, purpose, goals, objectives and commitment to service excellence.   

EDUCATION/EXPERIENCE

Graduation from an accredited college or university with a bachelor's degree in health education, nursing, social services, or -a healthcare related field is required. Master’s degree preferred.  An understanding of long-term support services and service coordination for a disabled population is required. Familiarity with information and computer systems is required.  Must exhibit thorough understanding of NCQA standards and HHSC regulations. Minimum of two years managerial experience is required. Experience in an HMO setting or managed care is required.

LICENSURE/ CERTIFICATIONS

If a Registered Nurse or Social Worker must be licensed in the State of Texas.