Less than 5 years experience • Managed Care & Health Insurance
Supervisor, UM - Bedford, NH
Innovative health plan continues to expand. Supervisor will lead and mentor the UM staff, including identifying opportunities for process improvement.
Benefits and perks are great – growth opportunities are unlimited!!!
• 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
• 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
Education/Experience: 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.
License/Certification: Current NH RN license (or able to obtain)