2 yrs related experience including lead role within Utilization Management
Has active PRC License
Responsible for providing technical direction, guidance and resources to UM staff on a day-to-day basis. Primary duties may include but are not limited to: Manages creation, launching and coordination and development of UM quality initiatives. Provides inputs to policies and processes impacting the operations. Coordinates with workforce for staffing requirements and scheduling of agents given leaves, absences and attrition. Reviews department policy and procedure manuals for accuracy. Collaborates with management and other cross functions in maintaining and exceeding set metrics. Prepares reports. Hires, trains, coaches, counsels, and evaluates performance of direct reports.