JOB SUMMARY:

The Utilization Management (UM) Supervisor is responsible for supervising the UM Coordinator Intake Team and assisting UM management. This position conducts daily reviews, provides leadership and guidance to staff to maintain a prioritized and productive workload. The UM Supervisor performs reviews and audits to assure quality, accuracy, and timeliness standards are being met and ability to provide guidance on how to accomplish standards and also ensures that employees are in compliance Medicare / Medicaid, TDI and all regulatory governing entities.

MINIMUM QUALIFICATIONS:

• Education/Specialized Training/Licensure: High School Diploma required: Associates Degree, Bachelors Degree in Healthcare Administration, Public Health, or related field preferred.
• Work Experience : 2 years of experience in a healthcare/managed care setting. Experience working with applicable state, federal, and third party regulations required. Medicare/Medicaid population experience required.
• Management Experience: 6 months or more of healthcare or health plan leadership experience required.
• Software Operated: Microsoft Office (Word, Excel, Outlook)
• Other Requirements: Able to work independently under general instructions
• Must be flexible to work alternative hours including the weekend and on call as needed

SPECIAL REQUIREMENTS:

• Communication Skills:
• Above Average Verbal (Heavy Public Contact)
• Writing /Composing: Correspondence / Reports
• Other Skills: Analytical, Medical Terminology, Research, Statistical,
• MS Word, MS Excel
• Advanced Education:Bachelors Degree Major: Bachelors Degree in Healthcare Administration, Public Health, or related field preferred.
• Work Schedule: Flexible
• RESPONSIBLE TO: Supervisor/Manager
• EMPLOYEE SUPERVISED: Staff