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Supervisor, Utilization Management

Company: Centene Coproration
Location: Scranton
Posted on: December 5, 2019

Job Description:

Description: 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

Keywords: Centene Coproration, Scranton , Supervisor, Utilization Management, Executive , Scranton, Pennsylvania

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