Provides supervision and monitoring of unlicensed staff (UM Specialists) responsible for all utilization management (UM) support duties, prioritizing adherence to regulatory, customer, and departmental performance standards.
Monitors and manages daily non-authorization processes, staff production and adherence to regulatory, customer, and departmental standards.
Oversees and organizes daily volume of work and manages assignments of UM staff.
Assists with providing employee training on specialized task processes.
Assists in the development of department workflows and implementations.
Consults with business partners on identified problems and interfaces with departmental staff on recommended resolutions.
Assists in data-gathering and analysis of reports regarding UM support activities.
Oversees preparation for audits involving UM support processes.
Identifies gaps in processes and works to resolve them.
Facilitates staff meetings.
Hires new staff, as needed, to ensure the ongoing success of the team, and provides coaching, as needed.
Other duties as assigned.
Other Job Requirements
Responsibilities
Minimum of 5 years in a healthcare operations focused position.Excellent research and analytical skills.Ability to work under tight deadlines.Self-starter with an approach that demonstrates strong attention to detail.Highly organized with excellent communication skills, including coordinating cross-functional team meetings and prioritizing projects/tasks.Strong work ethic and focus on process and achieving results.Strong working knowledge of Microsoft Office Product Suite.Excellent problem-solving skills with ability to supervise and motivate team members.
General Job Information
Title
SUPERVISOR, UTILIZATION MANAGEMENT SUPPORT SERVICES, MRX
Grade
22
Work Experience - Required
Compliance, Healthcare, Quality, Supervisory, Utilization Management
Work Experience - Preferred
Education - Required
GED, High School
Education - Preferred
Bachelors
License and Certifications - Required
License and Certifications - Preferred
Magellan Health, Inc. is proud to be an Equal Opportunity Employer and a Tobacco-free workplace. EOE/M/F/Vet/Disabled.Every employee must understand, comply with and attest to the security responsibilities and security controls unique to their position; and comply with all applicable legal, regulatory, and contractual requirements and internal policies and procedures.
Magellan is the employer of choice for hard working people interested in making a difference in the health care industry and in the communities where we work and live. Our strong culture of caring is the common thread in both our business strategy and our work environment. We value professional growth and development, total health and wellness, rewards and recognition as well as employee unity. Magellan is a place where you can thrive.
Magellan is committed to providing equal employment opportunities to employees and applicants for employment without regard to race, color, creed, religion, sex, gender identity and expression, sexual orientation, marital status, age, national origin, ancestry, citizenship, physical or mental disability, disabled veteran or veteran of the Vietnam Era status, or any other factors protected by law.
Magellan is committed to meeting applicable Federal labor and employment law posting requirements by providing necessary posters in a format which is easily accessible and conspicuous to all applicants. Copies of applicable posters are accessible by clicking here (https://www.magellanhealth.com/media/760295/mg-federal-contractors-applicant-english.pdf) .
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It has come to our attention that a false representative is contacting potential candidates and offering them work at home positions with Magellan Health. -Interviews- are conducted completely through email and the false job offer includes the promise of a check to be issued to the candidate for the purposes of setting up a home office.
Please know that Magellan Health does not interview any candidate through email, nor do we issue checks to candidates to set up home offices. All of our available positions are posted on legitimate job boards and our recruitment team directly contacts candidates should there be a fit.
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