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Dry Utilities Manager
1 day ago
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Dry Utilities Manager
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Timmons Group Raleigh, United StatesTimmons Group is seeking an experienced Dry Utilities Manager for our Urban Land Development Group located in our Raleigh, NC office. Civil engineering experience and dry utility construction experience preferred. The qualified candidate must be able Manager, Utilities, Civil Eng ...
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Dry Utilities Manager
1 week ago
Timmons Group Raleigh, United StatesJob Description · Job DescriptionJob Description · Timmons Group is seeking an experienced Dry Utilities Manager for our Urban Land Development Group located in our Raleigh, NC office. Civil engineering experience and dry utility construction experience preferred. The qualified c ...
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Case Manager Utilization Review
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Case Manager Utilization Review
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Case Manager Utilization Review
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Junior Estimator Cost Manager Civil Utilities
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Superintendent Structures
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Utility Superintendent
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Project Developer
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Project Manager
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Sr Project Manager
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Salesforce Developer
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Supervisor, Utilization Management - Raleigh, United States - Centene Corporation
Description
You could be the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective on workplace flexibility.
**Position Purpose:** Supervises Prior Authorization, Concurrent Review, and/or Retrospective Review Clinical Review team to ensure appropriate care to members. Supervises day-to-day activities of utilization management team.
+ Monitors and tracks UM resources to ensure adherence to performance, compliance, quality, and efficiency standards
+ Collaborates with utilization management team to resolve complex care member issues
+ Maintains knowledge of regulations, accreditation standards, and industry best practices related to utilization management
+ Works with utilization management team and senior management to identify opportunities for process and quality improvements within utilization management
+ Educates and provides resources for utilization management team on key initiatives and to facilitate on-going communication between utilization management team, members, and providers
+ Monitors prior authorization, concurrent review, and/or retrospective clinical review nurses and ensures compliance with applicable guidelines, policies, and procedures
+ Works with the senior management to develop and implement UM policies, procedures, and guidelines that ensure appropriate and effective utilization of healthcare services
+ Evaluates utilization management team performance and provides feedback regarding performance, goals, and career milestones
+ Provides coaching and guidance to utilization management team to ensure adherence to quality and performance standards
+ Assists with onboarding, hiring, and training utilization management team members
+ Leads and champions change within scope of responsibility
+ Performs other duties as assigned
+ Complies with all policies and standards
**Education/Experience:** Requires Graduate of an Accredited School Nursing or Bachelor's degree and 4+ years of related experience.
Knowledge of utilization management principles preferred.
**License/Certification:**
+ RN - Registered Nurse - State Licensure and/or Compact State Licensure required
Pay Range: $72, $130,100.00 per year
Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law. Total compensation may also include additional forms of incentives.
Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.