Supervisor Utilization Management - Medical Management

Providence • Irvine, CA

2d • Remote

About The Position

The Supervisor Utilization Management is responsible for providing day-to-day oversight for the general operations of the Utilization Review Specialists and works in cooperation with other supervisors, managers, and directors to provide leadership and guidance for Utilization Management staff. In addition to supervisory responsibilities, duties include all functions of UM support staff daily operations including high-volume call center organization and support, UM data entry workflows, department administrative support, specialty projects, and member-facing training and support including telephonic outreach and care coordination/navigation. Acts as a mentor and role model; problem-solving day-to-day issues and promotes team building that reflects the Providence mission and core values. Providence caregivers are not simply valued – they’re invaluable. Join our team at Providence Health Plan Partners and thrive in our culture of patient-focused, whole-person care built on understanding, commitment, and mutual respect. Your voice matters here, because we know that to inspire and retain the best people, we must empower them. Providence Health Plan welcomes 100% remote work for applicants who reside in the following states: Washington Oregon California

Requirements

• Bachelor's Degree in Health related field or an equivalent combination of education and experience.
• 2 years' experience with managed care services including population health initiatives, Affordable Care Act, Coordinated Care Organizations, Accountable Care Organizations, Medicare and Medicaid regulations.
• Experience with development of innovative and focused partnerships and programs which challenge the norm to support an ever-changing healthcare environment.
• Experience in cost stewardship using Lean principles or other means which increase effectiveness and cut waste.
• Experience with the latest trends in health education and behavior change.
• Demonstrated experience in project management, educational program development and implementation, and technology.

Nice To Haves

• Master's Degree
• Supervisory or lead experience.

Responsibilities

• Providing day-to-day oversight for the general operations of the Utilization Review Specialists.
• Working in cooperation with other supervisors, managers, and directors to provide leadership and guidance for Utilization Management staff.
• Performing all functions of UM support staff daily operations including high-volume call center organization and support, UM data entry workflows, department administrative support, specialty projects, and member-facing training and support including telephonic outreach and care coordination/navigation.
• Acting as a mentor and role model.
• Problem-solving day-to-day issues.
• Promoting team building that reflects the Providence mission and core values.

Benefits

• Our best-in-class benefits are uniquely designed to support you and your family in staying well, growing professionally, and achieving financial security.

What This Job Offers

• Job Type: Full-time
• Career Level: Manager