Job Supervisor Utilization Management Pennsylvania

Supervisor Utilization Management

Skills:3+ years of utilization management/quality improvement experience.   Current state's LPN, LVN, or RN license.    |  Location:Pennsylvania  ,  United States Of America

Views:53


Job description-$75,000-$85,000 (Harrisburg)
Position Purpose: Supervise the daily operations of the utilization management (UM) department

Supervise the daily operations of the UM staff

Ensure appropriate usage of resources in order to facilitate the UM process

Ensure compliance within applicable state program guidelines

Evaluate compliance policies and procedures and analyze/recommend enhancements

Assist with ensuring consistent data collection from UM staff that is used to assist the company in achieving corporate goals, to improve monitoring and reporting in order to meet external requirements

Identify opportunities for process improvements necessary to facilitate department functions

Educate staff as necessary to ensure consistent performance and adhere to standards

Assist UM Manager and Director with coordinating and facilitating system processes with providers, partners, vendors, and subcontractors as necessary

Qualifications:
Education/Experience: 3+ years of utilization management/quality improvement experience. Working knowledge and understanding of basic utilization management and quality improvement concepts. Previous experience as a lead in a functional area or managing cross functional teams on large scale projects.

License/Certification: Current state's LPN, LVN, or RN license.

Supervisor

More information about the job
Is Relocation Available?
Yes, nationwide
Is there a bonus structure?
8%
Are you open to sponsorship?
No
This position is:
New Position
Is there a possibility to work remote?
No
Is there equity?
No
Are there flexible work hours?
No
Does this position have direct reports?
Yes
Who does this position report to?
Manager, Utilization Management

What are the 3-4 non-negotiable requirements on this position?
3+ years of utilization management/quality improvement experience.
Working knowledge and understanding of basic utilization management and quality improvement concepts.
Previous experience as a lead in a functional area or managing cross functional teams on large scale projects.

Current state's LPN, LVN, or RN license.

What are the nice-to-have skills?
Managed care and/or health plan background is a plus. Hospital background.

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