Utilization Management Manager

🕒 3 days ago

🏢🏡 New York City – Hybrid

💵 $116.8k - $168.8k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

👔 Manager

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Healthfirst

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

Founded 1993

⚕️ Healthcare Insurance

💸 Finance

Healthcare Insurance • Finance • Medicare

Healthfirst is a health insurance provider dedicated to helping New Yorkers access affordable health coverage for individuals and families. With over 30 years of experience, Healthfirst offers a range of plans including Medicaid managed care, Medicare Advantage, long-term care, and essential health plans. The company focuses on providing quality healthcare options, comprehensive benefits, and support to ensure members can maintain their health and well-being.

📋 Description

• Provides daily oversight for Case Management teams • Oversees utilization management functions including timely authorizations • Develops and monitors goals for staff; provides ongoing feedback and coaching • Collaborates with medical staff and reviews medical charts to obtain information for appropriate utilization management • Allocate, monitor, and control resources while delegating and monitoring workloads • Develops and analyzes operational and analytical reports to monitor operational efficiency • Properly documents utilization management activities • Functions as a clinical resource for the multi-disciplinary care team

🎯 Requirements

• Associate’s degree • RN, LPN, LMSW, LMHC, LCSW, or any other relevant clinical license • Work experience demonstrating verbal and written communication skills • Experience working independently in a fast-paced environment that requires problem solving skills and handling multiple priorities simultaneously • Experience with Microsoft Office Suite applications including Excel, Word, Power Point and Outlook

🏖️ Benefits

• medical, dental and vision coverage • incentive and recognition programs • life insurance • 401k contributions