Utilization Management Representative Lead
1 month ago
We are seeking a highly skilled Utilization Management Representative Lead to join our team at Elevance Health. As a key member of our team, you will be responsible for providing technical guidance to UM Reps, ensuring quality control, and driving productivity.
Key Responsibilities- Provide technical guidance to UM Reps on complex customer service and call center experience.
- Conduct quality control services, including call monitoring and UMR level I, II, and III audits.
- Monitor daily phone activities to exceed NMIS standards and improve customer service levels.
- Assist in supervising the daily activities of a group of Behavioral Health Associates.
- Provide direction and guidance to less experienced team members.
- Assist manager with PTO scheduling and monitoring attendance.
- Handle escalated and unresolved calls from less experienced team members.
- Keep team members informed of any changes.
- Assist management by identifying areas of improvement and recommending solutions.
- HS diploma or equivalent and a minimum of 5 years related experience.
- Complex customer service or call center experience and medical terminology training.
- Knowledge of health plans, including familiarity with prior authorization and precertification process.
- Strong knowledge of managed benefit programs.
- Master's degree.
- Knowledge of contracts.
- Professional competencies, including oral, written, and interpersonal communication skills, problem-solving skills, facilitation skills, and analytical skills.
Elevance Health is a health company dedicated to improving lives and communities. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.
We offer a range of market-competitive total rewards, including merit increases, paid holidays, Paid Time Off, and incentive bonus programs. We operate in a Hybrid Workforce Strategy, requiring associates to work at an Elevance Health location at least once per week.
The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19.
-
Lead Management Consultant
4 weeks ago
Tallahassee, Florida, United States Empower Full timeJob DescriptionEmpower Your CareerAt Empower, we're committed to helping our associates grow and succeed in their careers. As a Lead Management Coordinator, you'll play a critical role in executing our lead lifecycle processes, working closely with EPW leadership to drive assets growth and retention.Key ResponsibilitiesDevelop and maintain a deep...
-
Principal Engineer Utilities
1 month ago
Tallahassee, Florida, United States Pasco County, FL Full timeJob Title: Principal Engineer UtilitiesWe are seeking a highly skilled and experienced Principal Engineer Utilities to join our team at Pasco County, FL. As a key member of our Utilities Engineering and Contract Management Department, you will be responsible for managing and overseeing complex projects, providing technical expertise, and ensuring compliance...
-
Senior Project Manager
4 days ago
Tallahassee, Florida, United States Pasco County, FL Full timeJob Title: Senior Project Manager - Utilities Engineering & Contract Management Pasco County, FL is seeking a highly skilled Senior Project Manager to join our Utilities Engineering & Contract Management team. As a key member of our team, you will be responsible for managing multiple projects simultaneously, ensuring timely completion, and maintaining...
-
Clinical Utilization Management Specialist
2 weeks ago
Tallahassee, Florida, United States CVS Health Full timeJob SummaryCVS Health is seeking a skilled Utilization Management Nurse Consultant to join our team. As a key member of our healthcare team, you will play a critical role in ensuring that our members receive the most appropriate and effective care possible.Key ResponsibilitiesUtilize clinical expertise to coordinate and document all aspects of the...
-
Managed Care Coordinator
3 days ago
Tallahassee, Florida, United States Orthopaedic Solutions Management Full timeJob SummaryOrthopaedic Solutions Management is seeking a highly skilled Credentialing Specialist to join our team. In this role, you will be responsible for implementing initial credentialing and re-credentialing functions for employed and contracted practitioners.Key ResponsibilitiesObtain and verify practitioner credentials, including Medicare, Medicaid,...
-
Managed Care Coordinator
3 days ago
Tallahassee, Florida, United States Orthopaedic Solutions Management Full timeJob SummaryWe are seeking a highly organized and detail-oriented Managed Care Coordinator to join our team at Orthopaedic Solutions Management. The successful candidate will be responsible for implementing initial credentialing and re-credentialing functions for employed and contracted practitioners, ensuring timely and accurate practitioner insurance plan...
-
Sales Representative
1 week ago
Tallahassee, Florida, United States Chief Cabinets LLC Full timeJob DescriptionChief Cabinets LLC is seeking a highly motivated and energetic Outside Sales Representative to join our team. In this role, you will be responsible for generating leads, attracting new clients, and closing deals. Your primary focus will be on developing and cultivating relationships with builders and remodelers in the Tallahassee area.Key...
-
Customer Service Lead
4 weeks ago
Tallahassee, Florida, United States Circle K Full timeLead Customer Service RepresentativeCircle K is seeking a highly skilled and experienced Lead Customer Service Representative to join our team. As a key member of our store team, you will be responsible for providing exceptional customer service, resolving customer issues, and leading a team of Customer Service Representatives.Key Responsibilities:Provide...
-
Sales Representative
4 weeks ago
Tallahassee, Florida, United States Chief Cabinets LLC Full timeJob OverviewWe are seeking a highly motivated and results-driven Outside Sales Representative to join our team at Chief Cabinets LLC. As a key member of our sales team, you will be responsible for generating leads, attracting new clients, and closing deals in the Tallahassee area.Key ResponsibilitiesDevelop and maintain strong relationships with existing and...
-
Sales Representative
3 days ago
Tallahassee, Florida, United States Chief Cabinets LLC Full timeJob Title:Outside Sales and Business DevelopmentJob Summary:We are seeking a highly motivated and energetic sales professional to join our team at Chief Cabinets LLC. As an Outside Sales Representative, you will be responsible for generating leads, attracting new clients, and closing deals in the Tallahassee area.Responsibilities:Develop and maintain...
-
Territory Account Representative
3 weeks ago
Tallahassee, Florida, United States OneBlood Full timeJob SummaryWe are seeking a highly motivated and results-driven Territory Account Representative to join our team at OneBlood. As a Territory Account Representative, you will be responsible for executing blood donor recruitment programs to meet goals for assigned territories. This is a unique opportunity to make a meaningful impact in the lives of others...
-
Customer Service Lead
3 weeks ago
Tallahassee, Florida, United States Circle K Full timeLead Customer Service RepresentativeCircle K is seeking a highly skilled and motivated Lead Customer Service Representative to join our team. As a key member of our store team, you will be responsible for providing exceptional customer service, resolving customer issues, and leading by example.Key Responsibilities:Provide prompt and courteous customer...
-
Territory Sales Representative
3 weeks ago
Tallahassee, Florida, United States OneBlood Full timeJob Title: Territory Account RepresentativeOverviewWe are seeking a highly motivated and results-driven Territory Account Representative to join our team at OneBlood. As a key member of our sales team, you will be responsible for executing blood donor recruitment programs and managing all aspects of the recruitment process to meet goals for assigned...
-
Customer Service Lead
3 days ago
Tallahassee, Florida, United States Circle K Full timeLead Customer Service RepresentativeCircle K is seeking a highly skilled and experienced Customer Service Lead to join our team. As a key member of our store management team, you will be responsible for providing exceptional customer service, resolving customer issues, and leading a team of Customer Service Representatives.Key Responsibilities:Provide prompt...
-
Territory Sales Representative
1 week ago
Tallahassee, Florida, United States OneBlood Full timeJob Title: Territory Account RepresentativeOneBlood is seeking a highly motivated and results-driven Territory Account Representative to join our team. As a key member of our sales team, you will be responsible for executing blood donor recruitment programs, developing and maintaining effective professional business relationships with donor drive...
-
Utility Excavation Specialist
2 months ago
Tallahassee, Florida, United States Southeast Utilities of Georgia, a Congruex company Full timeJob OverviewSoutheast Utilities of Georgia, a Congruex Company, is seeking a skilled UG Operator to enhance our construction team. We specialize in designing and building broadband and wireless communications infrastructure, enabling essential services across various sectors.Your RoleThe UG Operator will play a crucial role in our operations, responsible for...
-
Business Development Representative
2 days ago
Tallahassee, Florida, United States NCR VOYIX Full timeAbout NCR VOYIXNCR VOYIX is a leading global provider of digital commerce solutions for the retail, restaurant, and banking industries. With a rich history of innovation, we've been at the forefront of problem-solving through technology. Our solutions optimize banking operations, streamline restaurant services, enhance retail interactions, and foster trust...
-
Territory Sales Representative
4 weeks ago
Tallahassee, Florida, United States OneBlood Full timeJob Title: Territory Account RepresentativeOneBlood is seeking a highly motivated and results-driven Territory Account Representative to join our team. As a key member of our sales team, you will be responsible for executing blood donor recruitment programs, developing and maintaining effective professional business relationships with donor drive...
-
Territory Sales Representative
4 days ago
Tallahassee, Florida, United States OneBlood Full timeJob Title: Territory Account RepresentativeOverviewAs a Territory Account Representative at OneBlood, you will be responsible for executing blood donor recruitment programs to meet goals for assigned territories. This role requires strong communication and interpersonal skills to develop and maintain effective professional relationships with donor drive...
-
Customer Service Lead
2 weeks ago
Tallahassee, Florida, United States Circle K Full timeLead Customer Service RepresentativeCircle K is seeking a skilled and customer-focused Lead Customer Service Representative to join our team. As a key member of our store team, you will be responsible for providing exceptional customer service, resolving customer issues, and leading by example.Key Responsibilities:Provide prompt and courteous customer...