Supervisor Utilization Management Admin
Location: Milwaukee, Wisconsin, United States
Remote Opportunity: 0
Requisition Number: 2693
Position Title: Supervisor, UM Support
Provide appropriate leadership and supervision to the staff to ensure expectations of the health plans are met by monitoring authorization calls and phone statistics, facilitating resolution and resolving internal and external complaints and issues. The UM Support Supervisor coordinates and implements appropriate strategies for motivating team members and coordinates the management of these efforts.
PRIMARY JOB RESPONSIBILITIES:
- Monitor authorization calls and phone statistics for compliance with health plan and state guidelines and document results.
- Assess, recommend, and implement necessary policies and procedures to maintain compliance.
- Direct supervision of customer service staff.
- Coach, develop, performance manage and assist all staff members.
- Quality Monitor Customer Service staff, rate each employee monitored, and educate staff in areas where improvement is needed.
- Accountable for understanding individual contract and state requirements as they relate to outbound calls for new and existing Clients.
- Ensure all audit processes and any changes are clearly documented.
- Assist UM Audit Coordinator in compiling documentation and developing responses for UM audits as it relates to outbound calls.
- Identify any process changes or software enhancement needs based on audit findings.
- Ensure changes needed due to audit deficiencies are implemented into production.
- Coordinates and implements appropriate strategies for motivating team members.
- Preparation of performance and wage evaluations in accordance to company policy as necessary.
- Facilitate resolutions and resolve internal and external complaints and issues.
- Update management on complaints and issues.
- Approves attendance and company time off for team members.
- Determination and implementation of Performance Improvement Plans.
- Take the lead in the hiring process, including interviewing candidates.
- Provide clear written correspondence as needed.
- Respond to emails and voicemails as appropriate.
- On-going evaluation of policies and procedures, and develop and implement new efficiencies based on assessments.
- Support back-up phone assistance to other internal customer service teams as needed.
- Attend Market, Client, Operational and other meetings as needed.
- Represent the team and or department.
- Contribute to team effort by completing related projects as needed.
- Other duties as needed or required.
- High school diploma
- 2 years of related customer service or call center experience.
- 1 years of previous leadership or supervisory experience.
- Previous experience and proven abilities to effectively and proactively change process and make efficiencies.
- Professional and efficient verbal and written communication skills.
- Cooperative, professional and effective interaction skills with co-workers, company staff and visitors.
- Excellent interpersonal skills.
- Ability to prioritize and organize multiple tasks.
- Ability to remain organized with multiple interruptions.
- Good PC Skills.
- Excellent analytical ability.
- Required to attend additional training when requested/deemed necessary.
- Previous experience with computer software including Excel and MS Word (Power Point and Access a plus).
PHYSICAL DEMANDS: Incumbent must be able to communicate effectively. Requires overall light physical effort (up to 25lbs.) Manual dexterity and sitting is required in carrying out position own position responsibilities (i.e. use of personal computer). Ability to travel or move about within and outside serviced facilities required. Incumbent works primarily in either a private or shared office environment
Community / Marketing Title: Supervisor Utilization Management Admin
At DentaQuest, we believe that everyone should live life free of dental disease. As a purpose-driven, double bottom line company that is improving oral health for everyone, we are transforming the oral health system – from the way we provide care and pay for it, to how we talk about it and prioritize it in our policies and communities.
Meaningful change requires a revolution in oral health. We are redefining what it means to prevent disease and provide better access to care for everyone. We are going beyond the dental chair to reshape the oral health system, addressing total health and the social and cultural factors that impact it.
To make this revolution a reality, we harness our unique reach and insights to advance policy, financing, care, and the community. That means solving problems in a flexible and efficient way, testing and trialing to create new solutions and delivering measurable outcomes for the people we serve.
The people of DentaQuest have a common purpose, and we work together with passion, perseverance and focus to achieve a nation where no child suffers from the pain of tooth decay. Where adults keep all their teeth for their entire lives. Where every person has access to quality dental care.
Location_formattedLocationLong: Milwaukee, Wisconsin US
CountryEEOText_Description: Equal Employment Opportunity Statement: DentaQuest is committed to a policy of nondiscrimination and equal opportunity for all employees and qualified applicants without regard to race, color, religious creed, national origin, sex, age, disability, marital status, or sexual orientation.