Manager II Utilization Management

Anticipated End Date: Position Title:Manager II Utilization Management - Family CareJob Description: Title: Manager II Utilization Management  Hybrid 2: This role requires associates to be in-office 3 days per week, fostering collaboration and connectivity, while providing flexibility to support productivity and work-life balance. This approach combines structured office engagement with the autonomy of virtual work, promoting a dynamic and adaptable workplace.Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law.The Manager II Utilization Management is responsible for overseeing workflow and performance of lower level Utilization Management Managers. Ensures compliance with departmental policies and procedures. How you will make an impact:Implements short/long-term objectives and monitors results to assure attainment of goals. Performs audits to monitor efficiency and compliance with policies. Hires, trains, coaches, counsels, and evaluates performance of direct reports.Directs and oversees UM program operations in support of corporate and health plan management. Directs and collaborates with functional managers to develop and implement the steps necessary to manage program operations. Evaluates program operations to improve efficiency of UM operations, financial return, customer service, and provider engagement.Minimum Requirements:HS diploma or GED and a minimum of 5 years progressively complex customer service or call-center experience and supervisory experience; or any combination of education and experience which would provide an equivalent background. Preferred Skills, Capabilities, and Experiences:BA/BS in a clinical area plus RN, MFT or LCSW license preferred. 3 years of health care UM experience is highly preferred. Prior experience in Long Term Services and Supports (LTSS) in Wisconsin or with the program population is highly preferred. Knowledge of health plans, including familiarity with prior authorization and precertification process; knowledge of contracts and strong knowledge of managed benefit programs strongly preferred. For URAC accredited areas, the following professional competencies apply: Associates in this role are expected to have strong oral, written and interpersonal communication skills, problem-solving skills, facilitation skills, and analytical skills.Job Level:ManagerWorkshift:Job Family:CUS > Service OperationsPlease be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.Who We AreElevance Health is a health company dedicated to improving lives and communities – and making healthcare simpler. 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.How We WorkAt Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business.We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process.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 and Influenza. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws.Elevance Health is an Equal Employment Opportunity employer, and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact for assistance. Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.