Central Utilization Management Supervisor
Sutter Health
Sacramento, California, US
Job highlights
Qualification
Associate's Degree - Equivalent experience will be accepted in lieu of the required degree or diploma. 5 years recent relevant experience. CERTIFICATION & LICENSURE. RN - Registered Nurse of California. Knowledge of health care benefits and utilization protocols relating to the determination of health service requests. Familiarity of medical coding, including, but not limited to, International Classification of Diseases (ICD), Current Procedure Terminology (CPT), Healthcare Common Procedure Coding System (HCPCS). Knowledge of authorization processing computer systems, word processing and spreadsheet programs. Demonstrated knowledge of medical management statistics relating to utilization management. Leadership skills, including team building, and coaching/mentoring with the ability to motivate and engage others. Verbal and written communication and interpersonal skills. Demonstrates organizational and time management skills, with the ability to prioritize multiple projects while delivering quality service/achieving business results
Responsibility
Responsible for overall supervision of the utilization management process. Implements policies and procedures to ensure efficient daily operations of intake authorization requests. Monitors the utilization management and quality management activities, supervises workflow, and contributes to the hiring, disciplinary and termination processes for the staff. Serves as a general operations resource to the department
Benefits
Job Description
Description
We are so glad you are interested in joining Sutter Health! Organization: SHSO-Sutter Health System Office-Valley Position Overview: Responsible for overall supervision of the utilization management process. Implements policies and procedures to ensure efficient daily operations of intake authorization requests. Monitors the utilization management and quality management activities, supervises workflow, and contributes to the hiring, disciplinary and termination processes for the staff. Serves as a general operations resource to the department. Job Description: EDUCATION: Associate's Degree - Equivalent experience will be accepted in lieu of the required degree or diploma. PREFERRED EXPERIENCE AS TYPICALLY ACQUIRED IN: 5 years recent relevant experience. CERTIFICATION & LICENSURE RN - Registered Nurse of California SKILLS AND KNOWLEDGE: Knowledge of health care benefits and utilization protocols relating to the determination of health service requests. Familiarity of medical coding, including, but not limited to, International Classification of Diseases (ICD), Current Procedure Terminology (CPT), Healthcare Common Procedure Coding System (HCPCS). Knowledge of authorization processing computer systems, word processing and spreadsheet programs. Demonstrated knowledge of medical management statistics relating to utilization management. Leadership skills, including team building, and coaching/mentoring with the ability to motivate and engage others. Verbal and written communication and interpersonal skills. Demonstrates organizational and time management skills, with the ability to prioritize multiple projects while delivering quality service/achieving business results. Job Shift: Varied Schedule: Full Time Shift Hours: 8 Days of the Week: Monday - Friday Weekend Requirements: As Needed Benefits: Yes Unions: No Position Status: Non-Exempt Weekly Hours: 40 Employee Status: Regular Sutter Health is an equal opportunity employer EOE/M/F/Disability/Veterans. Pay Range is $68.59 to $109.75 / hour The salary range for this role may vary above or below the posted range as determined by location. This range has not been adjusted for any specific geographic differential applicable by area where the position may be filled. Compensation takes into account several factors including but not limited to a candidate’s experience, education, skills, licensure and certifications, department equity, training and organizational needs. Base pay is just one piece of the total rewards program offered by Sutter Health. Eligible roles also qualify for a comprehensive benefits package.