Supervisor, Utilization Management Support

This is a fully remote position, open to applicants in United States.

📋 Description

• Oversee the daily operations of the Utilization Management Coordinators, ensuring the prompt and precise handling of prior authorization requests.

• Guide, mentor, and develop team members, supporting their skills and career aspirations while tracking productivity, accuracy, and overall performance.

• Directly supervise the daily functions of the Utilization Management Coordinator Team to guarantee timely and accurate authorization request processing.

• Manage the scheduling of clinical reviews and peer-to-peer (P2P) discussions between providers and Medical Directors.

• Strategically plan, organize, and coordinate the team's activities and projects to meet specific, measurable objectives and deadlines.

• Serve as the domain expert for Utilization Management AI workflows, overseeing the entire lifecycle which includes building, executing, implementing, and evaluating the performance and enhancement of AI/LLM-enabled tools.

• Foster and sustain strong collaborations with clinical leadership, provider relations, claims, and other internal departments to ensure smooth UM operations.

⛳️ Requirements

• Minimum of 3 years of experience in utilization management or prior authorization.

• At least 1 year of experience in a leadership or supervisory role is essential.

• Familiarity with Medicare Advantage or managed care systems.

• Understanding of prior authorization processes, clinical review protocols, and regulatory standards (e.g., Medicare Advantage).

• Strong skills in organization, communication, and operational management.

• Exceptional problem-solving and analytical abilities.

• Experience working in a fast-paced, high-volume setting.

• Proficient in healthcare systems, EHRs, and various reporting tools.

• Proven track record of driving technology-enabled workflow enhancements, particularly using AI/LLM tools.

🏝️ Benefits

• Employer-sponsored health, dental, and vision insurance with low or no premium.

• Generous paid time off policy.

• Monthly stipend of $100 for mobile or internet expenses.

• Stock options available for all employees.

• Bonus opportunities for all positions, excluding Director and above; commission eligibility for Sales roles.

• Parental leave program.

• 401K retirement plan.

• And more....