Supervisor Utilization Management - Remote FL

Profile

Description

The Supervisor, Utilization Management will lead a team of Utilization Coordinators that supports the Prior Authorization team for the Florida Medicaid market. The Supervisor will lead a team on non-clinical associates who support the coordination, documentation and communication of medical services and/or benefit administration determinations. The Supervisor, Utilization Management works within specific guidelines and procedures; applies advanced technical knowledge to solve moderately complex problems; receives assignments in the form of objectives and determines approach, resources, schedules and goals.

Responsibilities

The Supervisor, Utilization Management will be responsible for the following:


Oversight of Prior Authorization non-clinical associates.
Manages a team of associates that support and performs the non-clinical administrative tasks related to utilization management.
Regularly make decisions around team's schedule, plans and daily operations.
Coordinates and provides day-to-day oversight to associates as well as ensures consistency in execution across the team which includes holding team members accountable for following established policies.
Collaborates with management and top professionals/specialist in selection of methods, techniques and analytical approach.


Required Qualifications


2 or more years of experience leading teams and/or projects within utilization management or the healthcare industry.
Microsoft technical experience in Word, Excel, Outlook and Teams
Ability to work independently under general instructions and with a team
Must be passionate about contributing to an organization focused on continuously improving consumer experiences
Must be available to work Monday-Friday 8:00-5:00 EST
Must reside in the state of Florida


Additional Requirements to Work At Home


Must have a separate room with a locked door that can be used as a home office to ensure you and your patients have absolute and continuous privacy while you work.
Must have the ability to provide a high-speed DSL or cable modem for a home office (Satellite and Wireless Internet service is NOT allowed for this role). A minimum standard speed for optimal performance of 10x1 (10mbs download x 1mbs upload) is required.


Preferred Qualifications


Prior supervisory experience highly preferred
Health Plan experience
Prior Medicaid experience
Call center or triage experience
Bilingual is a plus


Additional Information


This is a non-clinical role and a Nursing license is not required. However, applicants with Nursing License will still be considered based on experience and fit for this role.


Interview Process

As part of our hiring process, we will be using an exciting interviewing technology provided by Modern Hire, a third-party vendor. This technology provides our team of recruiters and hiring managers an enhanced method for decision-making.

If you are selected to move forward from your application prescreen, you will receive correspondence inviting you to participate in a pre-recorded Voice Interview and/or an SMS Text Messaging interview. If participating in a pre-recorded interview, you will respond to a set of interview questions via your phone. You should anticipate this interview to take approximately 10-15 minutes.

If participating in a SMS Text interview, you will be asked a series of questions to which you will be using your cell phone to answer the questions provided. Expect this type of interview to last anywhere from 5-10 minutes. Your recorded interview(s) via text and/or pre-recorded voice will be reviewed and you will subsequently be informed if you will be moving forward to next round of interviews.

Scheduled Weekly Hours

40

Company info

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