Managed Care Liaison Supervisor, PIH Health - Home ...

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 HospiceRequired SkillsRequired:California Registered Nurse LicenseBachelor of Science in NursingDriver''s LicenseValid auto insurancePrevious experience in Home Health or HospiceExperience with OASIS Assessments, all related documentation and regulatory standards for documentation.Knowledge of Title 22 and Medicare Coverage ManualAble 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 NursingCertified 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 or follow us on Facebook, Twitter, or Instagram.

Created: 2025-11-15