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UnitedHealth Group - Floresville, 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 quality care services for WellMed members. This role involves coordinating with various teams, managing prior authorization requests, and providing leadership and administrative support to staff in a fast-paced call center environment. The position offers a hybrid work model, allowing flexibility between home and office work 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 environment (hybrid model)
- Opportunities for professional development
- Recognition for performance
- Supportive team atmosphere
