Utilization Management Business Lead
6 days ago
Job Overview:
We are seeking a highly skilled Utilization Management Assistant Manager to join our team at Carelon Global Solutions.
The successful candidate will provide technical direction, guidance and resources to UM staff on a day-to-day basis, ensuring seamless operations and exceptional patient outcomes.
Primary Responsibilities:
- Develop and implement UM quality initiatives, collaborating with cross-functional teams to drive business growth and excellence.
- Contribute to the development of policies and processes impacting UM operations, ensuring alignment with industry standards and best practices.
- Coordinate staffing requirements and scheduling of agents, considering leaves, absences, and attrition to maintain optimal workforce levels.
- Review department policy and procedure manuals for accuracy, ensuring compliance with regulatory requirements.
- Collaborate with management and other stakeholders to maintain and exceed set metrics, driving business success and patient satisfaction.
- Prepare reports and evaluate performance of direct reports, providing coaching and development opportunities to ensure career growth and employee engagement.
Professional Competencies:
- The ideal candidate will possess strong oral, written, and interpersonal communication skills, problem-solving skills, facilitation skills, and analytical skills, enabling them to excel in this role and contribute to the success of our organization.
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