Non Clinical Intake UM Review Supervisor

Role Overview

In this role, you will provide daily operational leadership to a team of 13 remote Utilization Management Technicians. This team supports the intake of physical health utilization management reviews specific to First Choice by Select Health of South Carolina. As one of 6 Supervisors, Utilization Management Review Non Clinical, you will ensure all processes are completed and deadlines are met and in compliance with local, state, and federal regulatory standards.

• Provides technical assistance and coaching to staff in a prompt and ongoing basis to ensure accuracy and completion of work according to regulatory guidelines, AmeriHealth Caritas policies, procedures, and process standards.
• Identifies the need for and develops policies and procedures, and training and education plans to assure that Care Connector or other pertinent staff process standards are clearly documented, and meet/support organizational goals.
• Maintains a current knowledge base of Intake or other appropriate staff processes and trains/ mentors staff.
• Works collaboratively with Utilization Management Supervisors, Managers and Directors to identify and resolve workflow issues and obstacles to efficient departmental and individual performance.
• Maintains current knowledge of all Utilization Management initiatives, attends assigned meetings and actively communicates with departmental representatives Intake staff or pertinent staff work duties and participates in the development of Policies & Procedures, Standard Operating Processes, Training development and presentations to direct reports and other departments
• May utilize work force management systems, as dictated by leadership, to effectively monitor the processing of inbound calls/ contacts. Responsible for preparing reports and conducting analysis of UM Technicians or pertinent staff productivity and attainment of goals. Performs other related duties and projects as assigned.

Education/Experience:

• High School Diploma or GED required; Associate's Degree preferred
• Minimum of 3 years experience supervising staff in a contact center environment with processes to provide accountability in high volume call environment, preferred working in a health care/managed care environment.
• Strong knowledge base of health care resources, ideally with managed care experience.
• Excellent communication skills, oral written; excellent listening skills.
• Solid knowledge of contact center processes to provide accountability in high volume call environment, managing audits/reports.
• Demonstrated ability to promote excellent customer service skills.
• Skill in working with diverse teams and ability to collaborate with various disciplines within a market or Plan is highly desirable.

Our Comprehensive Benefits Package

Flexible work solutions including remote options, hybrid work schedules, Competitive pay, Paid time off including holidays and volunteer events, Health insurance coverage for you and your dependents on Day 1, 401(k) Tuition reimbursement and more.