In this role, you will be responsible for the management, direct supervision and coordination of clinical and/or nonclinical management staff, including utilization management and intensive care management staff, providing expertise in designated programs.
In this role, you will be responsible for coordination of appropriate, cost-effective services that enhance a member's quality of life, focus on a member's optimal level of independence, and reduces inappropriate utilization of medical services.
In this role, you will review necessary repairs with customers and associates and address questions or concerns, consistently monitor and assure high quality customer service is provided by associates on a daily basis.
This position is also responsible for supervising and managing teams of personnel who support utilization management, transitions of care and discharge planning activities. This position ensures compliance with NCQA, state, federal and other regulatory accreditation standards.