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Clinical Administrative Supervisor - Phoenix, AZ

Job Location:
Phoenix, AZ
Metro Area:
AZ - Phoenix
Company Name: UnitedHealth Group
Website:  Click to Visit
UnitedHealth Group
Up for the challenge of a lifetime? Join and lead a team of the best and the brightest to find bold new ways to proactively improve the health and quality of life of our millions of customers. You'll find a wealth of dynamic opportunities to grow and develop as we work together to heal and strengthen our health care system. Ready? It's time to do your life's best work.(sm) In this role, you will supervise and motivate a work team to achieve team objectives, including meeting the company's standards of production and quality while maintaining applicable turnaround times and standards. You will lead by example with a positive attitude and demonstrate the fundamentals of being a team player. What makes your clinical career greater with UnitedHealth Group? You'll work within an incredible team culture; a clinical and business collaboration that is learning and evolving every day. And, when you contribute, you'll open doors for yourself that simply do not exist in any other organization, anywhere.In this position, you will ensurethat the notification coordinators comply with all applicable State and Federal laws and consent decrees, as well as the applicable accrediting regulatory review agencies, including but not limited to CMS, NCQA, HIPAA, and all UHC policies and procedures as applicable. Primary Responsibilities: Ensure a timely acknowledgement and response to all authorization documents received providing appropriate feedback to address processing issues Administer the process for handling authorizations received from non-participating providers Respond to provider inquiries that have been received by the escalation and case resolution department in a timely manner Communicate with provider and/or office staff, various health plans administered and/or other employees to research and verify information provided on authorization documents when appropriate using a professional, courteous and cheerful manner Supervise the process for accurate additions of new patients to the patient database Facilitate team staff meetings in order to review and implement processes that allow for smooth and efficient operations Review with management individualized reports reflecting daily production and quality in order to accurately measure and monitor predetermined company, position and individual goals Work together with all staff members, as well as other departments, to resolve issues and assist each other This team is responsible for reaching out to members to give them a verbal notification of approval or adverse results - Direct Reports:15 + Supervises day to day operations of the notification coordinators by monitoring case load and productivity on a daily basis Completes Monthly scorecards for the staff Resource to staff- knowledgeable about the day to day operations and familiar with P&Ps, state grids, resource tools, staff lists (IDs, MS sign-on, phone number list) HR duties Monitor queues, work assignments, compliance and adherence to policies and procedures. Monitor and address Reports (error reports, pend reports, etc.) as assigned Serves as a catalyst for implementing an appropriate risk assessment process designed to identify and correct deficiencies. Must be innovative and bring new ideas for efficiencies Maintains extensive knowledge of regulatory and applicable accrediting body requirements becoming a Compliance resource for the team Demonstrates flexibility, availability, and dependability to conform to position responsibilities Establish and maintain good working relationships throughout the company to support goals and objectives

Qualifications:

Required Qualifications: Bachelors degree or equivalent experience in the healthcare field 2+ years of Supervisory experience 5+ years of Customer Service experience 2+ years of experience Supervising in a metrics based environment 2+ years experience with acting as a Subject Matter Expert or Lead with Utilization Management Letter Generation Requirements Intermediate (or higher) level of proficiency with Microsoft Office Proven analytical and problem solving skills while managing multiple tasks simultaneously Ability to work independently or in a team environment Demonstrated excellent written and verbal communication skills The applicant should possess a high attention to detail, exceptional documentation abilities, and organizational skills Proven ability to handle multiple tasks simultaneously by working independently, as well as part of a team, in a fast paced environment Knowledge of State Employer and Individual UR / UM Applicability and Medicare Federal Guidelines for Notifications Preferred Qualifications: Managed Care experience in a Care Coordination role Call Center experience Previous experience supervising remote employees Careers with UnitedHealthcare. Let's talk about opportunity. Start with a Fortune 6 organization that's serving more than 85 million people already and building the industry's singular reputation for bold ideas and impeccable execution. Now, add your energy, your passion for excellence, your near-obsession with driving change for the better. Get the picture? UnitedHealthcare is serving employers and individuals, states and communities, military families and veterans where ever they're found across the globe. We bring them the resources of an industry leader and a commitment to improve their lives that's second to none. This is no small opportunity. It's where you can do your life's best work.(sm) Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law. UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment. Job Keywords: Clinical Administrative Supervisor, Phoenix, Arizona, AZ
 
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