Utilization Management Supervisor

Advance your career as a Outpatient UM Supervisor working with a community leader in healthcare.

This Jobot Job is hosted by: Randy Kallick
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Salary: $95,000 - $101,000 per year

A bit about us:

Based in San Leandro, CA we are a federally qualified health center providing business administrative support.

As a Utilization Management Supervisor you will support the Utilization staff. You will be a subject matter expert for business systems and supervising outpatient utilization.

Why join us?

• Competitive Base Salary.
• Excellent Benefits Package.
• Accelerated Career Growth.
• Great Work Environment.

Job Details

Job Details:

We are seeking a dynamic and experienced Utilization Management Supervisor to join our team in the medical industry. This is a permanent position where the successful candidate will play a pivotal role in the coordination and execution of our utilization management programs. The Utilization Management Supervisor will ensure the efficient and effective utilization of healthcare services, improving the health outcomes of patients while reducing unnecessary costs and improving overall healthcare delivery. This position offers an exciting opportunity to work closely with a multidisciplinary team of healthcare professionals, including doctors, nurses, and other healthcare providers.

Responsibilities:

1. Oversee the daily operations of the utilization management department, ensuring all activities align with organizational goals and regulatory requirements.
2. Develop and implement utilization management policies and procedures to ensure compliance with federal and state regulations.
3. Supervise and mentor a team of utilization management nurses and other staff, providing guidance and support as needed.
4. Coordinate with healthcare providers, patients, and insurance companies to facilitate proper healthcare service utilization.
5. Review and analyze patient care data to identify trends, improve service delivery, and reduce unnecessary costs.
6. Conduct regular audits to ensure adherence to utilization management standards and practices.
7. Collaborate with other department leaders to establish strategic plans and objectives.
8. Lead continuous improvement initiatives to enhance the effectiveness of the utilization management program.
9. Address and resolve any issues or concerns related to utilization management.
10. Maintain up-to-date knowledge of healthcare regulations, medical procedures, and insurance policies.

Qualifications:

1. Bachelor's degree in Nursing, Healthcare Administration, or a related field. A Master's degree will be an added advantage.
2. Must be a Registered Nurse with a valid license.
3. A minimum of 3 years of experience in Utilization Management in a healthcare setting.
4. Prior supervisory or managerial experience is highly desirable.
5. Proficient in healthcare databases, medical software, and Microsoft Office Suite.
6. Excellent understanding of healthcare regulations and medical procedures.
7. Strong leadership and team management skills.
8. Exceptional communication and interpersonal skills.
9. Ability to analyze complex medical data and make informed decisions.
10. Proven ability to work under pressure and meet deadlines.
11. Strong commitment to improving patient care and healthcare service delivery.

Interested in hearing more? Easy Apply now by clicking the "Apply Now" button.