Utilization Management Plan Oversight Manager
10 hours ago
We are seeking a highly skilled Utilization Management Plan Oversight Manager to join our team at AmeriHealth Caritas. As a key member of our healthcare leadership team, you will be responsible for overseeing the development and implementation of utilization management plans that ensure high-quality, cost-effective care for our members.
Key Responsibilities:- Develop and implement utilization management plans that align with regulatory requirements and company policies.
- Collaborate with cross-functional teams to ensure seamless integration of utilization management processes.
- Monitor and analyze data to identify trends and areas for improvement in utilization management.
- Develop and implement process improvements to optimize utilization management outcomes.
- Ensure compliance with regulatory requirements and company policies.
- Bachelor's degree in a related field.
- Current and unrestricted RN license in Ohio.
- 3 years of utilization/case management experience in a relevant scope.
- 3 years of relevant clinical practice experience.
- Demonstrated ability to assess departmental work quality and develop/implement process improvements.
- Experience managing multiple processes and influencing change.
- Demonstrated competency in use of healthcare data.
- Competitive salary and benefits package.
- Opportunities for professional growth and development.
- Collaborative and dynamic work environment.
- Recognition and rewards for outstanding performance.
AmeriHealth Caritas is a mission-driven organization dedicated to improving the health and well-being of our members. We offer a comprehensive benefits package, flexible work arrangements, and a commitment to diversity, equity, and inclusion. If you are a motivated and results-driven professional looking for a challenging and rewarding opportunity, we encourage you to apply.
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