Overview The Supervisor Utilization Management is responsible for providing day-to-day oversight for the general operations of the Utilization Review Specialists and works in cooperation with other supervisors, managers, and directors to provide leadership and guidance for Utilization Management staff. In addition to supervisory responsibilities, duties include all functions of UM support staff daily operations including high-volume call center organization and support, UM data entry workflows, department administrative support, specialty projects, and member-facing training and support including telephonic outreach and care coordination/navigation. Acts as a mentor and role model; problem-solving day-to-day issues and promotes team building that reflects the Providence mission and core values.
Providence caregivers are not simply valued – they’re invaluable. Join our team at Providence Health Plan Partners and thrive in our culture of patient-focused, whole-person care built on understanding, commitment, and mutual respect. Your voice matters here, because we know that to inspire and retain the best people, we must empower them.
Responsibilities
Provide day-to-day oversight for the general operations of Utilization Review Specialists.
Collaborate with other supervisors, managers, and directors to lead Utilization Management staff.
Manage high-volume call center organization and support; oversee UM data entry workflows and department administrative support.
Lead specialty projects and provide member-facing training and support, including telephonic outreach and care coordination/navigation.
Serve as a mentor and role model; address day-to-day issues and promote team building aligned with Providence values.
Required Qualifications
Bachelor's Degree in health-related field or an equivalent combination of education and experience.
2 years' experience with managed care services including population health initiatives, ACA, Coordinated Care Organizations, Accountable Care Organizations, Medicare and Medicaid regulations.
Experience developing innovative partnerships and programs to support a changing healthcare environment.
Experience in cost stewardship using Lean principles or equivalent methods to increase effectiveness and reduce waste.
Experience with the latest trends in health education and behavior change.
Demonstrated experience in project management, educational program development and implementation, and technology.
Preferred Qualifications
Master's Degree.
Supervisory or lead experience.
Salary Range by Location
California: Humboldt — Min: $39.45, Max: $61.24
California: All Northern California - Except Humboldt — Min: $44.26, Max: $68.71
California: All Southern California - Except Bakersfield — Min: $39.45, Max: $61.24
California: Bakersfield — Min: $37.84, Max: $58.75
Oregon: Non-Portland Service Area — Min: $35.28, Max: $54.77
Oregon: Portland Service Area — Min: $37.84, Max: $58.75
Washington: Western - Except Tukwila — Min: $39.45, Max: $61.24
Washington: Southwest - Olympia, Centralia & Below — Min: $37.84, Max: $58.75
Washington: Tukwila — Min: $39.45, Max: $61.24
Washington: Eastern — Min: $33.67, Max: $52.28
Washington: South Eastern — Min: $35.28, Max: $54.77
Why Join Providence?
Our best-in-class benefits are uniquely designed to support you and your family in staying well, growing professionally, and achieving financial security. We take care of you, so you can focus on delivering our Mission of caring for everyone, especially the most vulnerable in our communities.
Accepted applicants should be aware that changes in benefits may occur with various factors including Legal Employer, FTE, Union, location, time-off plan policies, and benefit offerings.
About Providence
At Providence, our strength lies in Our Promise of “Know me, care for me, ease my way.” We provide best-in-class benefits and foster an inclusive workplace where diversity is valued and everyone is essential, heard and respected. Our 120,000 caregivers serve in over 50 hospitals, over 1,000 clinics, and a full range of health and social services across multiple states. We are committed to serving the poor and vulnerable with a long-standing history.
Posted are the minimum and maximum wage rates on the wage range for this position. The successful candidate's placement on the wage range will be determined based upon relevant experience and other factors. Base pay range may include additional compensation such as shift differentials, standby/on-call, overtime, premiums, and bonuses.
About the Team
Providence Shared Services provides functional and system support services for our family of organizations across several states. We focus on supporting our Mission by delivering a robust foundation of services and sharing expertise.
Providence is proud to be an Equal Opportunity Employer. We are committed to an inclusive workforce free from discrimination and harassment. We value diversity and provide equal opportunities for advancement.
Requisition ID: 429374
Company: Providence Jobs
Job Category: Health Information Management
Job Function: Revenue Cycle
Job Schedule: Full time
Job Shift: Day
Career Track: Leadership
Department: 5018 HCS MEDICAL MANAGEMENT OR REGION
Address: CA Irvine 15480 Laguna Canyon Rd
Work Location: Providence System Offices Discovery Park-Irvine
Workplace Type: Remote
Pay Range: $See Posting - $See Posting
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