Lead, Utilization Management Operations

Medica; Madison (WI); On-site; USD 70,000 - 105,000; Full time

Job summary

Medica in Madison, WI, seeks a Supervisor, Utilization Management - Ops to lead the Review Coordinators team in Health Management. You will drive daily operations, ensure regulatory compliance, and implement process improvements across Utilization Management and related departments.

The role partners with leaders across Medica to deliver efficient, high-quality provider submissions processing, triage, and prior authorizations, while coaching staff and managing performance.

Qualifications

• Bachelor's degree or equivalent combination of education and work experience.
• 3+ years of direct leadership experience in healthcare.
• 3+ years healthcare experience.

Responsibilities

• Lead and supervise the Review Coordinators team to ensure smooth daily operations.
• Identify opportunities for process improvements and oversee SOP updates.
• Coordinate cross-functional initiatives across Utilization Management and related departments.

Skills

Leadership

Communication

Analytical thinking

Collaboration

Adaptability

Education

Bachelor's degree

Job description

Medica in Madison, WI, seeks a Supervisor, Utilization Management - Ops to lead the Review Coordinators team in Health Management. You will drive daily operations, ensure regulatory compliance, and implement process improvements across Utilization Management and related departments.

The role partners with leaders across Medica to deliver efficient, high-quality provider submissions processing, triage, and prior authorizations, while coaching staff and managing performance.