HMO Supervisor  

Job Summary:

Responsible for the hospital liaison officer when transacting with HMO companies.

Duties and Responsibilities

1. Supervises and directs the activities of the HMO team.
2. Develop, establish and maintain strong 3rd party relationships with HMOs as potential sources of increased patient census.
3. Create and negotiate standard deals, terms of payment, when possible, for each type of organization;
4. Ensure that each 3rd party relationship is covered by a contract or Memorandum of Agreement (MOA) as applicable.
5. Monitors the performance of staff.
6. Encourages the professional growth and development of staff through such activities as workshops, seminars, independent study, and other continuing education opportunities.
7. Prepares special reports as requires.
8. Ensure that team is effectively and efficiently performing within the bounds of their duties and job responsibilities.
9. Supervises a multi-functional unit of claim professionals and support staff.
10. Provides day to day leadership to claim team in support of department initiatives and strategies in cost containment, case file handling, customer service and quality.
11. Consistently monitors workflows to maximize accuracy and efficiency. Maintains an acceptable level of service and customer satisfaction and retention.
12. Provides input in the quality review process.
13. Monitors unit goals, objectives, processes, procedures and systems.

Job Requirements:

Education

• College Degree holder of any business course.

Experience

• Has held at least 2-year experience in handling HMO in a clinic or hospital setting
• Has held at least 2 years of supervisory position

Skills

• Very good written and verbal communication skills,
• Proficient in MS Office tools: Powerpoint, Excel, Word
• Advanced project management and organizational skills
• Motivational and able to manage and implement personnel programs