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MedicaPosted 3 weeks ago

Supervisor, Utilization Management - Operations

$70,200–$105,315 year

On-siteMadison, Wisconsin, United States or St. Louis, Missouri, United States

Full TimeSenior LevelLarge

Job Summary

Supervise a team of Review Coordinators by ensuring efficient workflows, resolving escalated issues, and conducting root cause analysis on complex cases. Oversee end-to-end operational processes for triage, prior authorizations, and inpatient notifications while developing and updating standard operating procedures. Drive process improvements, facilitate cross-functional initiatives, and manage departmental projects from planning through execution. Provide direct leadership through regular one-on-ones, performance reviews, and coaching to support team growth. Maintain accessibility for problem-solving and ensure compliance with regulatory guidelines and departmental standards.

Required Qualifications

  • Bachelor's degree or equivalent combination of education and work experience
  • 3+ years of direct leadership experience, either through managerial experience or through leadership roles that require coaching, mentorship and performance evaluation
  • 3+ years healthcare experience
  • Eligibility to work in the US
  • Must be legally authorized to work in the United States at the time of application
  • Employment is contingent on verification of identity and eligibility to work in the United States
  • This position is an Office role, which requires an employee to work onsite, on average, 3 days per week
  • Candidates located near one of the following office locations: Minnetonka, MN, Madison, WI, or St. Louis, MO

Desired Qualifications

  • Prior leadership experience in Utilization Management, Prior Authorization, or related health plan operations
  • Experience leading and developing teams in a virtual, metrics-driven environment
  • Demonstrated experience coaching, mentoring, and developing employees, including performance management and annual performance reviews
  • Experience leading change initiatives and implementing operational processes that improve performance, efficiency, and business outcomes
  • Experience managing projects and driving cross-functional initiatives from planning through execution

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