Strategic Operations Manager, Utilization Management Administration

The Supervisor, UM Administration

Contributes to administration of utilization management. The Supervisor, UM Administration works within thorough, prescribed guidelines and procedures; uses independent judgment requiring analysis of variable factors to solve basic problems; collaborates with management and top professionals/specialists in selection of methods, techniques, and analytical approach.

Responsibilities

The Supervisor, UM Administration provides non-clinical support for the policies and procedures ensuring best and most appropriate treatment, care or services for members. Decisions are typically related to schedule, plans, and daily operations. Performs escalated or more complex work of a similar nature, and supervises a group of typically support and technical associates; coordinates and provides day-to-day oversight to associates. Ensures consistency in execution across the team. Holds team members accountable for following established policies.

Required Qualifications

• Minimum 3 years’ experience in a team leadership role, examples include Subject Matter, Expert, SME, Quality Coaching, or Project Lead.
• Minimum 3 years customer service experience with heavy or high volume, call quality, with emphasis on the ability to de-escalate communications.
• Intermediate or better proficiency using Microsoft Office Word, Excel, and PowerPoint.
• Able to give direction and make sound business decisions, while exercising good judgment and engaging in ethical behavior.
• Exceptional verbal and written communication skills.
• Strong attention to detail.

Additional Requirements / Adherence

Workstyle: Hybrid – Remote work

Location: Kentucky / Oklahoma

Preferred Location: Louisville

The business will request commuting to the Louisville market office if you reside within a 50-mile radius of Louisville.

Schedule:

• Must be able to work a scheduled shift between 8:00 AM – 8:00 PM Monday through Friday.
• Possible weekends and rotating holiday coverage to support business needs.

Travel: Anticipated travel up to 1 time annually to the Louisville market office

Training/Start Date: January 29th, 2024

Work at Home Guidance

To ensure Home or Hybrid Home/Office associates’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office associates must meet the following criteria:

• At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is recommended; wireless, wired cable or DSL connection is suggested.
• Satellite, cellular and microwave connection can be used only if approved by leadership.
• Associates who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense.
• Humana will provide Home or Hybrid Home/Office associates with telephone equipment appropriate to meet the business requirements for their position/job.
• Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.

Preferred Qualifications

• Supervisory experience including hiring, training, coaching, and up to termination, preferably in a call center setting.
• Experience in an operational setting.
• General understanding of economic, financial, and operational concepts.

Additional Information

Interview Format

As part of our hiring process, we will be using an exciting interviewing technology provided by Modern Hire, a third-party vendor. This technology provides our team of recruiters and hiring managers an enhanced method for decision-making.

If you are selected to move forward from your application prescreen, you will receive an email correspondence inviting you to participate in a pre-recorded Voice Interview and/or an SMS Text Messaging interview. (please be sure to check your spam or junk folders often to ensure communication isn’t missed) If participating in a pre-recorded interview, you will respond to a set of interview questions via your phone. You should anticipate this interview to take approximately 10-15 minutes.

If participating in an SMS Text interview, you will be asked a series of questions to which you will be using your cell phone to answer the questions provided. Expect this type of interview to last anywhere from 5-10 minutes. Your recorded interview(s) via text and/or pre-recorded voice will be reviewed and you will subsequently be informed if you will be moving forward to next round of interviews.

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Scheduled Weekly Hours

40

Not Specified

0