Mgr I Utilization Management (Us)

Description

How you will make an impact:

Responsible for the daily management of the department.

Primary duties may include, but are not limited to:

• Participates in strategic planning and budget processes.
• Supervises workflow and performance of associates.
• Develops and implements associate training.
• Assists in coordination and development of UM quality initiatives.
• Prepares reports. Hires, trains, coaches, counsels, and evaluates performance of direct reports.
• Provides quality control services such as call monitoring.
• Ensures compliance with departmental policies and procedures.
• Performs audits to monitor efficiency and compliance with policies.
• Works in conjunction with other UM staff to improve service quality initiatives, develop audit tools, and meet NMIS and other quality standards.

Minimum Requirements:

• Requires HS diploma or equivalent and a minimum of 4 years operational experience in a progressively complex customer service or call center; or any combination of education and experience which would provide an equivalent background.

Preferred Skills, Capabilities and Experiences:

• Experience in Utilization Management is a must.
• Must have previous managerial or team lead experience.
• Long-term care experience is strongly preferred.
• The candidate must reside in Florida.
• Associates in this role are expected to have strong oral, written and interpersonal communication skills, problem-solving skills, facilitation skills, and analytical skills.
• RN or BSN preferred.

Please be advised that Elevance Health only accepts resumes from agencies that have a signed agreement with Elevance Health. Accordingly, Elevance Health is not obligated to pay referral fees to any agency that is not a party to an agreement with Elevance Health. Thus, any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.

Be part of an Extraordinary Team

Elevance Health is a health company dedicated to improving lives and communities – and making healthcare simpler. A Fortune 20 company with a longstanding history in the healthcare industry, we are looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve. You will thrive in a complex and collaborative environment where you take action and ownership to solve problems and lead change. Do you want to be part of a larger purpose and an evolving, high-performance culture that empowers you to make an impact?

We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.

The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19. If you are not vaccinated, your offer will be rescinded unless you provide – and Elevance Health approves – a valid religious or medical explanation as to why you are not able to get vaccinated that Elevance Health is able to reasonably accommodate. Elevance Health will also follow all relevant federal, state and local laws.

Elevance Health has been named as a Fortune Great Place To Work in 2022, has been ranked for five years running as one of the 2023 World’s Most Admired Companies by Fortune magazine, and is a growing Top 20 Fortune 500 Company. To learn more about our company and apply, please visit us at careers.ElevanceHealth.com. Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact [email protected] for assistance.