Utilization Management Ops Supervisor

Medica; Minnetonka (MN); On-site; USD 70,000 - 120,000; Full time

Job summary

Medica is a nonprofit health plan serving Minnesota, Nebraska, Wisconsin, Missouri, and beyond. This Supervisor, Utilization Management - Ops role leads the review coordinator team to ensure efficient triage, provider inquiries, and end-to-end operational processes.

It requires strong leadership, adherence to regulatory standards, and collaboration across Health Management and other segments. The position emphasizes achieving operational excellence, guiding staffing and performance management,

Qualifications

• Bachelor's degree or equivalent combination of education and work experience.
• 3+ years of direct leadership experience in managerial or coaching roles.
• 3+ years healthcare experience.
• Preferred: leadership in Utilization Management or related health plan operations.
• Experience leading teams in a virtual, metrics-driven environment.
• Experience coaching, mentoring and conducting performance reviews.
• Experience managing projects and cross-functional initiatives.

Responsibilities

• Oversees daily operations of the review coordinator team to meet standards and regulatory guidelines.
• Identifies and initiates process improvements and drives operational excellence across departments.
• Leads staffing, hiring, onboarding and performance management of direct reports.
• Collaborates with leaders across Medica to drive effective outcomes and continuous improvement.
• Ensures policy adherence and effective communication across the department.

Skills

Leadership

Communication

Analytics

Project management

Mentoring

Education

Bachelor's degree

Job description

Medica is a nonprofit health plan serving Minnesota, Nebraska, Wisconsin, Missouri, and beyond. This Supervisor, Utilization Management - Ops role leads the review coordinator team to ensure efficient triage, provider inquiries, and end-to-end operational processes.

It requires strong leadership, adherence to regulatory standards, and collaboration across Health Management and other segments. The position emphasizes achieving operational excellence, guiding staffing and performance management,