14 days old

Supervisor of Utilization Management - Monarch Health- Irvine, CA

Irvine, CA 92606
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  • Job Code
    860428

Monarch HealthCare is one of the largest associations of physicians and health care professionals in Orange County and Long Beach. Our network gives you lots of access to specialists, hospitals, skilled nursing, urgent care and more so you have the perfect fit for good health. Monarch is part of OptumCare, a care delivery organization that improves patient health and helps make health care work better. 

 

The Supervisor of Utilization Management is responsible for supervising the nurses and coordinators by implementing and maintaining an efficient and effective flow of information through the utilization management process.  The Supervisor in collaboration with the Manager ensures compliance with all regulatory standards that include state, federal, NCQA, HEDIS, performance improvement, health plan audits and all accreditation criteria.  I addition, the Supervisor ensures all medically necessary services are reviewed according to MHC's internal guidelines along with all regulation and delegated standards.


 *Schedule: Monday - Friday 8:00AM - 5:00PM* No nights, weekends or holidays.

Primary Responsibilities: 
  • In collaboration with the Manager, the Supervisor recruits, interviews, hires and effectively on board new staff.
  • Ensures compliance with budgetary requirements.
  • Develops implements and monitors tools that evaluate employee productivity against established benchmark standards in a timely manner.
  • Adjust workflow responsibilities in line with staff expertise and availability.
  • Develops, implements, maintains policy and procedures and stand operation procedures.
  • Ensures proper patient care coordination in utilizing appropriate regulatory standards.
  • Oversees file maintenance within the department to include: health plan and ancillary contracts, data reports, and referral and denial supporting documentation and other tools to assist utilization management staff with their duties.
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Posted: 2020-03-14 Expires: 2020-04-13

UnitedHealth Group is the most diversified health care company in the United States and a leader worldwide in helping people live healthier lives and helping to make the health system work better for everyone.

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Supervisor of Utilization Management - Monarch Health- Irvine, CA

UnitedHealth Group
Irvine, CA 92606

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