This job is closed
We regret to inform you that the job you were interested in has been closed. Although this specific position is no longer available, we encourage you to continue exploring other opportunities on our job board.
UnitedHealth Group - New Braunfels, TX
posted 2 months ago
About the position
The Supervisor of Utilization Management (UM) at UnitedHealth Group is responsible for overseeing the daily operations of the UM department, ensuring the delivery of cost-effective and quality care services to WellMed members. This role involves coordinating with various teams, providing leadership support, and managing performance metrics in a fast-paced call center environment. The position offers a hybrid work model, allowing flexibility to work from home and the office in Texas.
Responsibilities
- Performs daily oversight of the UM platform queues to meet established performance metrics
- Oversees prior authorization inventory and regulatory timeframes
- Supervises all aspects of the UM expedited and standard requests inventory and service timeframes
- Assists with the hiring and training of new staff as needed
- Applies employee performance management techniques through job-related coaching, training and development activities
- Conducts routine audits on UM reviews to ensure adherence to CMS regulations
- Produces daily, weekly and monthly UM reports
- Conducts routine staff meetings
- Conducts provider education sessions on WellMed UM processes
- Performs all other related duties as assigned
Requirements
- High school diploma or GED equivalent
- 3+ years of related experience with 2+ years in a supervisory capacity
- 1+ years of managed care experience in Prior Authorization or Claims Review
- Medical terminology, ICD-9 and CPT knowledge
- Proficiency with Microsoft Office applications
Nice-to-haves
- Medical Assistant (MA) certification
Benefits
- Flexible work from home and office options
- Opportunities for professional development
- Recognition for performance
- Supportive work environment
