Supervisor, Operations - Long Beach, United States - Blue Cross Blue Shield companies

Description

The Utilization Management (UM) Intake team manages intake of prior authorization and concurrent review for all BCS lines of business .

In this role you will manage a team of front-line Clinical Service Coordinators and Leads, focusing on coaching/engagement, quality, production metrics and inventory management to meet regulatory turn-around times.

In addition, you will manage and support work that will have a direct impact on departmental performance metrics, change management and transformation initiatives.

Your primary focus of work in UM Intake will be the Commercial/Medicare lines of business as a subject matter expert and support the Medi-Cal line of business as needed.

• Responsible for a team of UM Intake (fax, phone, portal and other methods) Clinical Service Coordinators and multiple Leads
• Responsible for daily operations and people management functions
• Responsible for daily authorization inventory, call management and turn-around time (TAT) management to ensure internals SLAs and regulatory timelines are met
• Consult and make recommendations to management on operational issues
• Utilize/Analyze reports for tracking and trending dept. and team performance to UM Goals and Initiatives
• Foster a great place to work, communicating clear roles and responsibilities
• Build successful working relationships across the organization
• Use concepts and abilities to manage processes, operations, procedural changes, workloads and change management
• Apply policies and procedures within Medical Care Solutions
• Provide regular coaching to each team member, including audit and performance feedback, corrective actions, performance improvement, skill development, recognition and PDP creation/enhancement
• Responsible for gathering data and monthly reporting of individual performance, production, audits, 1.1 meeting summaries to Sr. Manager
• Conduct regular Team Meetings for consistency in communication of operations, gage understanding of policies and work processes and aligned approach to daily work
• Manage onboarding of new team members and security requests for team
• Create and manage goals and Employee Engagement action plans
• Participate in UM transformation initiatives and projects as necessary to provide input as subject matter expert, impact to operations and assist with change management for UM Intake