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Supervisor, Utilization Management

Company: Meridian Illinois
Location: Hull
Posted on: January 15, 2022

Job Description:

You could be the one who changes everything for our 25 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, multi-national organization, you'll have access to competitive benefits including a fresh perspective on workplace flexibility.
Position Purpose:Supervise the daily operations of the utilization management (UM) department

  • Supervise the daily operations of the UM staff

  • Ensure appropriate usage of resources in order to facilitate the UM process

  • Ensure compliance within applicable state program guidelines

  • Evaluate compliance policies and procedures and analyze/recommend enhancements

  • Assist with ensuring consistent data collection from UM staff that is used to assist the company in achieving corporate goals, to improve monitoring and reporting in order to meet external requirements

  • Identify opportunities for process improvements necessary to facilitate department functions

  • Educate staff as necessary to ensure consistent performance and adhere to standards

  • Assist UM Manager and Director with coordinating and facilitating system processes with providers, partners, vendors, and subcontractors as necessary

  • For MCOs, supervise the Transition of Care staff and provide face to face contact with inpatient members at assigned hospitals
    Comprehensive Benefits Package:

    • Flexible work solutions including remote options, hybrid work schedules and dress flexibility

    • Competitive pay

    • Paid Time Off including paid holidays

    • Health insurance coverage for you and dependents

    • 401(k) and stock purchase plans

    • Tuition reimbursement and best-in-class training and development
      Education/Experience:3+ years of utilization management/quality improvement experience. Working knowledge and understanding of basic utilization management and quality improvement concepts. Previous experience as a lead in a functional area or managing cross functional teams on large scale projects.

      Licenses/Certifications: Current state's RN license

      Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.

Keywords: Meridian Illinois, Columbia , Supervisor, Utilization Management, Executive , Hull, Missouri

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