Manager II Utilization Management - Family Care

Elevance Health • Waukesha, WI

34d • Hybrid

About The Position

Title: Manager II Utilization Management Hybrid 2: This role requires associates to be in-office 3 days per week, fostering collaboration and connectivity, while providing flexibility to support productivity and work-life balance. This approach combines structured office engagement with the autonomy of virtual work, promoting a dynamic and adaptable workplace. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law. The Manager II Utilization Management is responsible for overseeing workflow and performance of lower level Utilization Management Managers. Ensures compliance with departmental policies and procedures. How you will make an impact:

Requirements

• HS diploma or GED and a minimum of 5 years progressively complex customer service or call-center experience and supervisory experience; or any combination of education and experience which would provide an equivalent background.

Nice To Haves

• BA/BS in a clinical area plus RN, MFT or LCSW license preferred.
• 3 years of health care UM experience is highly preferred.
• Prior experience in Long Term Services and Supports (LTSS) in Wisconsin or with the program population is highly preferred.
• Knowledge of health plans, including familiarity with prior authorization and precertification process; knowledge of contracts and strong knowledge of managed benefit programs strongly preferred.

Responsibilities

• Implements short/long-term objectives and monitors results to assure attainment of goals.
• Performs audits to monitor efficiency and compliance with policies.
• Hires, trains, coaches, counsels, and evaluates performance of direct reports.
• Directs and oversees UM program operations in support of corporate and health plan management.
• Directs and collaborates with functional managers to develop and implement the steps necessary to manage program operations.
• Evaluates program operations to improve efficiency of UM operations, financial return, customer service, and provider engagement.

Benefits

• We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.

What This Job Offers

• Job Type: Full-time
• Career Level: Manager
• Industry: Insurance Carriers and Related Activities
• Education Level: High school or GED
• Number of Employees: 5,001-10,000 employees