Utilization Management Supervisor

Franciscan Alliance, Inc.; United States; Remote; USD 82,000 - 113,000; Full time

Job summary

Franciscan Alliance is seeking a Supervisor Utilization Management to lead the Centralized Utilization Management department. The role focuses on staffing, staff development, and delivering high-quality patient outcomes while maintaining strong relationships with internal and external customers.

This position is remote with up to 20% travel. The incumbent will supervise a team, ensure compliance with HFAP and regulatory requirements, and drive performance improvement across the care continuum.

Qualifications

• Bachelor’s Degree in Nursing is required.
• Active Indiana RN license is required.
• At least 5 years of nursing/patient care experience; 2 years in utilization or case management preferred.

Responsibilities

• Maintain inter- and intra-departmental communications, care management services.
• Participate in performance improvement initiatives; implement processes to drive satisfaction.
• Coordinate and ensure compliance with HFAP, state and federal agencies for utilization/denial management.
• Supervise direct reports with coaching, performance evaluations, and staff planning.
• Make personnel decisions and manage interviews.
• Oversee Utilization Management operations with Manager and Director to ensure proper utilization and denial management.

Skills

Nursing experience

Staff supervision

Utilization/Denial management

Education

Bachelor’s Degree in Nursing

Indiana RN license

Job description

Work From Home

Work From Home Work From Home, Indiana 46544

The Supervisor Utilization Management is responsible for the direct supervision of the daily operations of the Centralized Utilization Management department in order to assure that utilization management needs are addressed. This position ensures appropriate staffing levels, ongoing educational opportunities, and employee satisfaction to maintain operational commitment. The Supervisor maintains and enhances relationships with internal and external customers and peers across the continuum in order to facilitate excellent outcomes for patients and Franciscan.

WHO WE ARE

With 12 ministries and access points across Indiana and Illinois, Franciscan Health is one of the largest Catholic health care systems in the Midwest. Franciscan Health takes pride in hiring coworkers that provide compassionate, comprehensive care for our patients and the communities we serve.

WHAT YOU CAN EXPECT

• Maintain inter- and intra-departmental communications, special projects, programs, policies, and procedures as well as care management services.
• Participate and educate team in performance improvement initiatives. Implement processes to satisfaction with those we are privileged to serve.
• Coordinate and maintain compliance with HFAP, state and federal agencies pertaining to Utilization/Denial management activities.
• Supervise direct reports and manage the performance of individuals through ongoing coaching, feedback, and development to motivate, engage and drive a high performing team.
• Make decisions for direct reports in assigned function and performs people management activities, such as, performance evaluations, disciplinary actions, staff planning, and interviews.
• Supervise and maintain Utilization Management operations in collaboration with the Manager and Director, including ensuring appropriate utilization and denial management.

QUALIFICATIONS

• Bachelor’s Degree in Nursing required
• Active Indiana Registered Nurse (RN) license required
• 5 years of Nursing/Patient Care required
• 2 years of Utilization or Case Management experience preferred

TRAVEL IS REQUIRED:

Up to 20%

JOB RANGE:

Supervisor Utilization Management: $82,347.20 – $113, 235.20

INCENTIVE:

Not Applicable

EQUAL OPPORTUNITY EMPLOYER

It is the policy of Franciscan Alliance to provide equal employment to its employees and qualified applicants for employment as otherwise required by an applicable local, state or Federal law.

Franciscan Alliance reserves a Right of Conscience objection in the event local, state or Federal ordinances that violate its values and the free exercise of its religious rights.

Franciscan Alliance is committed to equal employment opportunity.

Franciscan provides eligible employees with comprehensive benefit offerings. Find an overview on thebenefit section of our career site, jobs.franciscanhealth.org.