Utilization Management Team Supervisor

2 weeks ago


Redding, California, United States Partnership HealthPlan of California Full time

Utilization Management Team Supervisor

Company: Partnership HealthPlan of California

Overview:

The role involves overseeing and guiding a team of utilization management professionals to meet departmental objectives. This position is crucial in providing the necessary support and resources to ensure optimal productivity and quality of service.

Key Responsibilities:

  • Deliver daily leadership and training to the utilization management team
  • Coordinate staff schedules and manage work assignments
  • Conduct performance assessments and provide constructive feedback
  • Engage in recruitment and onboarding activities
  • Maintain accurate patient documentation and assist in provider reporting
  • Organize meetings with community healthcare providers
  • Review and suggest improvements to departmental policies and procedures
  • Address provider concerns and manage caseloads as necessary
  • Assess the appropriateness of care and oversee special initiatives

Qualifications:

Education and Experience:

Possession of an Associate or Bachelor's degree in nursing with an active RN license. A minimum of 3-5 years in a supervisory role and at least 1 year of experience in managed care is required. Familiarity with utilization management practices is preferred.

Special Skills, Licenses, and Certifications:

Current RN license in California, with Case Management certification being advantageous. Strong organizational and communication abilities are essential.

Performance-Based Competencies:

Understanding of regulatory standards, exceptional organizational skills, proficiency in computer applications, and the capability to handle multiple projects and priorities effectively.

Work Environment and Physical Demands:

Ability to operate a computer, prioritize tasks, and travel occasionally. Must be capable of lifting items weighing up to 10 lbs.

Expectations:

  • Deliver exceptional service to clients
  • Encourage collaboration among team members
  • Uphold safety standards
  • Adhere to organizational policies and procedures

Compensation Range:

$120,000 - $156,735.06

Disclaimer:

This job description is representative and may be subject to modifications. The employer retains the right to adjust responsibilities based on organizational needs.



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