Supervisor of Utilization Management - Long Term Support Service

-; New York (NY); Remote; USD 80,000 - 100,000; Full time

Job summary

Join a leading healthcare organization as a Full-Time Supervisor of Utilization Management. This role involves supervising a dedicated team, enhancing the quality of care, and optimizing resource utilization. With a remote work environment, you will balance professional and personal life while making a significant impact in healthcare. Ideal candidates will have a BSN, RN license, and experience in utilization review and supervision.

Benefits

Medical Insurance

Dental Insurance

Vision Insurance

Life Insurance

Paid Time Off

Qualifications

• Minimum two years utilization review experience at a Managed Care Organization.
• One year's experience in supervisory role in healthcare.

Responsibilities

• Supervise a team of registered nurses and guide them through prior authorization reviews.
• Monitor daily clinical reviews to ensure timely processing of requests.

Skills

Leadership

Organizational Skills

Problem Solving

Communication

Education

BSN

Graduate of an accredited nursing program

Tools

Microsoft Excel

Microsoft PowerPoint

Microsoft Word

Job description

Join VillageCare as a Full-Time Supervisor of Utilization Management - Long Term Support Service and take center stage in transforming healthcare delivery. This is an exciting opportunity to make a meaningful impact on the lives of individuals while leading a dedicated team. Your problem-solving skills and customer-centric approach will be vital in optimizing resource utilization, ultimately enhancing the quality of care. Embrace the flexibility of a remote work environment that empowers you to balance your professional and personal life.

As part of our forward-thinking organization, you'll collaborate with passionate colleagues in a high-performance culture that values excellence and integrity. Here, you will not only thrive in your role but also contribute to an energetic team committed to innovation and quality service. You will be given great benefits such as Medical, Dental, Vision, Life Insurance, and Paid Time Off. This is your chance to elevate your career while making a difference in the health care industry!

Must reside in NY, NJ or CT

we're VillageCare

VillageCare is a community-based, not-for-profit organization serving people with chronic care needs, as well as seniors and individuals in need of continuing care and managed care services. Our mission is to promote healing, better health and well-being to the fullest extent possible. Our care is offered through a comprehensive array of community and residential programs, as well as managed care. VillageCare has delivered quality health care services to individuals residing within New York City for over 45 years.
What would you do as a Supervisor of Utilization Management - Long Term Support Service

As the Full-Time Supervisor of Utilization Management - Long Term Support Services at VillageCare, you will play a crucial role in enhancing the quality of care provided to our clients. You will supervise a team of registered nurses and act as a subject matter expert, guiding them through prior authorization reviews for long-term support services. Your responsibilities will include monitoring daily clinical reviews to ensure timely processing of requests, supporting the director in addressing complaints and quality of care concerns, and providing comprehensive education on the benefits offered at VillageCareMAX. Additionally, you may perform clinical review duties as needed and assist with quality initiatives in preparation for audits. Through performance evaluations and coaching, you will cultivate a high-performing team while contributing to the development of departmental objectives.

This position not only offers a chance to lead but also allows you to make a significant impact in the healthcare landscape.
Does this sound like you?

To excel as the Full-Time Supervisor of Utilization Management - Long Term Support Services at VillageCare, candidates must possess a blend of clinical expertise, leadership capabilities, and strong organizational skills. A graduate of an accredited nursing program with a BSN is essential, along with a current unrestricted NYS RN license. A minimum of two years of utilization review experience within a Managed Care Organization is required, along with at least one year in a supervisory role in healthcare.

Familiarity with precertification processes and knowledge of Medicaid and Medicare regulations will be advantageous. Proficiency in Microsoft Excel, PowerPoint, and Word is necessary, with a willingness to learn advanced software skills. Ideal candidates will demonstrate a passion for excellence and the ability to apply InterQual Care Guidelines and coverage limitations effectively.

Strong prioritization skills and capability to manage multiple projects will ensure success in this dynamic role.

Knowledge and skills required for the position are:

• Education: Graduate of an accredited nursing program
• BSN required. Advanced degree preferred.
• Licensure: Current unrestricted NYS RN license to practice professional nursing with no restrictions or must obtain within 3 months of hire.
• Certifications: URAC/CCM preferred, not required
• Experience: Minimum two years utilization review experience at a Managed Care Organization or Health Plan required.
• One year's experience in supervisory role in healthcare
• One-year recent precertification experience preferred
• Some knowledge of Microsoft Excel, Power Point and Word required
• Knowledge of Medicaid and/or Medicare regulations required.
• Demonstrates passion and commitment to excellence
• Can apply InterQual Care Guidelines
• Can understand and apply coverage guidelines and benefit limitations
• Understands and adapts appropriately to issues related to communication cognitive or other barriers
• Strong organizational skills and the ability to prioritize and follow through on multiple projects in a timely manner
• Possesses basic computer skills and demonstrates a willingness to learn more advanced skills

Connect with our team today!

Applying for this position is a walk in the park if you feel it's a good fit for you. Best of luck!

VillageCare is an Equal Opportunity Employer.