Utilization Management Supervisor

University of California - Los Angeles Health
United States, California, Los Angeles
Dec 18, 2024
Description Take on an important leadership role within an award-winning health system. Help improve patient experiences and operational efficiency as part of a world-class healthcare team. Take your career in an exciting new direction. You can do all this and more at UCLA Health. As a key leader within our Medicare Advantage team, you willbe responsible for assisting with the day-to-day management of the UM department and coordinators. This will involve coordinating staff schedules to efficiently handle incoming referrals and phone call volume. You will develop workflows, desktop procedures, forms, training materials, and protocols for achieving team objectives and key performance indicators. You will hire and train non-clinical coordinator staff as well as manage and monitor their production and quality performance. This position involves researching and resolving simple and complex patient/provider issues related to the authorization and claims process. You will also conduct performance evaluations, counsel employees, and take disciplinary action as necessary. Salary Range: $68,800 -141,00/annually Note: This posted position is 1 of 2 positions available for hire. All applicants will apply through this requisition and if selected will be hired into one of the available positions. Qualifications We're seeking a self-motivated, team-focused, deadline-driven, detail-oriented leader with: High school diploma, GED or equivalent required Two or more years of experience managing staff in a healthcare environment Two or more years of managed care or health plan experience preferred Experience processing ambulatory commercial, Medicare Fee for Service, and Medicare Advantage prior authorizations desired Knowledge of the HMO referral process, eligibility verification, and health plan benefit interpretation a plus Excellent critical thinking, organizational, and problem-resolution skills required Ability to work effectively across functional areas of the company. Computer proficiency with Microsoft Excel and Word Ability to multi-task and work with frequent interruptions Strong communication skills Ability to work well with ambiguity and stressful situations Ability to maintain confidentiality of patient and business records UCLA Health is a world-renowned health system with four award-winning hospitals and more than 260 community clinics throughout Southern California. We're also home to the world-class medical research and clinical education capabilities of the David Geffen School of Medicine. Through the efforts of our outstanding people, we have become Los Angeles' trusted provider of exceptional, compassionate patient care. If you're looking to experience greater challenge and fulfillment in your career, you can at UCLA Health.