Supervisor, Utilization Management Support

🔥 15 hours ago

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Devoted Health

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

Founded 2017

🏥 Healthcare

⚕️ Healthcare Insurance

🧘 Wellness

Healthcare • Healthcare Insurance • Wellness

Devoted Health is a healthcare company that offers Medicare Advantage plans designed to provide comprehensive health coverage with added benefits like dental, eyewear, gym memberships, and prescription drugs at competitive rates. The company emphasizes member support and service, ensuring that clients can easily navigate their benefits and access needed healthcare services. Devoted Health is committed to helping customers save money and enhance their health and wellness through a complete package of benefits and support.

📋 Description

• Manage the day-to-day operations of the Utilization Management Coordinators, ensuring timely and accurate processing of prior authorization requests. • Lead, coach, and develop staff, mentoring them on their competencies and career goals while monitoring productivity, accuracy, and performance. • Directly manage daily operations of the Utilization Management Coordinator Team to ensure timely and accurate processing of authorization requests. • Oversee the coordination of clinical reviews and peer-to-peer (P2P) scheduling between providers and Medical Directors. • Plan, organize, and coordinate the team's work and initiatives to ensure achievement of specific, measurable goals and deadlines. • Act as the domain owner for Utilization Management AI workflows for the team, responsible for the full lifecycle, including building, executing, implementing, and monitoring the performance and refinement of AI/LLM-enabled tools. • Cultivate and maintain strong partnerships with clinical leadership, provider relations, claims, and other internal teams to support seamless UM operations.

🎯 Requirements

• 3+ years of utilization management or prior authorization experience. • 1+ year of prior leadership or supervisory experience required. • Experience in Medicare Advantage or managed care. • Knowledge of prior authorization workflows, clinical review processes, and regulatory requirements (e.g., Medicare Advantage). • Strong organizational, communication, and operational management skills. • Excellent problem-solving and analytical skills. • Experience in a fast-paced, high-volume environment. • Proficiency with healthcare systems, EHRs, and reporting tools. • Experience driving technology-enabled workflow improvements, particularly with AI/LLM tools.

🏖️ Benefits

• Employer sponsored health, dental and vision plan with low or no premium • Generous paid time off • $100 monthly mobile or internet stipend • Stock options for all employees • Bonus eligibility for all roles excluding Director and above; Commission eligibility for Sales roles • Parental leave program • 401K program • And more....