Supervisor, UM - ORLANDO
Growing national MCO is adding to the leadership team in Orlando.
Supervise the daily operations of the utilization management (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
-3+ years of utilization management/quality improvement experience.
-Working knowledge and understanding of basic utilization management and quality improvement concepts.
-Previous experience as a lead in a functional area or managing cross functional teams on large scale projects.
-FL LPN, LVN, or RN license.
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