Supervisor UM Administration Central Region

Profile

Description

The Supervisor, UM Administration contributes to administration of utilization management. The Supervisor, UM Administration works within thorough, prescribed guidelines and procedures; uses independent judgment requiring analysis of variable factors to solve basic problems; collaborates with management and top professionals/specialists in selection of methods, techniques, and analytical approach. Must support compliance related functions under the UMAC teams specifically QIO, letter creation and P2P for coverage purposes.

Responsibilities

We value people and if you succeed, we succeed! The Supervisor, UM Administration contributes to the administration of utilization management. The Supervisor works within prescribed guidelines and procedures; uses independent judgement requiring analysis of variable factors to solve basic problems; collaborates with management and clinical professionals.

Effectively manages attendance, schedules, assignments, and compliance expectations to ensure adequate coverage during traditional and nontraditional business hours (weekend, evenings, and holidays as applicable) to support the needs of the business

Provides oversight, education, support, and coaching to ensure associates' performance meets expectations and regional operational goals/metrics

Support the daily management and operations of the department

Implements and executes policies and processes necessary to support the business need and maintain compliance with regulatory requirements

#LI-Remote

Required Qualifications

1-3 years' experience in a healthcare setting working in a team leadership or supervisory position

Must have experience leading and managing a team of associates

Experience using a UM Platform or Provider Portal

Proficiency in Microsoft Office Word, Excel, Outlook and PowerPoint

Able to give direction and make sound business decisions

Ability to exercise sound judgement and engage in ethical behavior

Exceptional verbal and written communication skills

Strong attention to detail and time management skills

Must be passionate about contributing to an organization focused on continuously improving consumer experiences

Preferred Qualifications

Associate Degree

Experience in an operational setting

General understanding of healthcare

Previous supervisory experience in a call center setting

Work-At-Home Requirements

At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is recommended; wireless, wired cable or DSL connection is suggested

Satellite, cellular and microwave connection can be used only if approved by leadership

Associates who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense

Humana will provide Home or Hybrid Home/Office associates with telephone equipment appropriate to meet the business requirements for their position/job

Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information

Additional Information

10% of travel may be required in the future based on business needs

This role will have up to 16 direct reports

Hours are: Monday-Friday 8am-5pm or 9am-6pm CST, this role may require an on-call rotation schedule including after normal business hours, weekends and holidays

Preference is for the candidate to reside within the 9 states located in this region, we will consider candidates that live in other states outside this region, but you must work in the CST zone

#LI-Remote

Scheduled Weekly Hours

40

Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our https://www.humana.com/legal/accessibility-resources?source=Humana_Website.

Company info

Humana Inc.
Website : http://www.humana.com