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CareSource

This job description is not all inclusive. CareSource reserves the right to amend this job description at any time. CareSource is an Equal Opportunity Employer. We are dedicated to fostering an environment of belonging that welcomes and supports individuals of all backgrounds.

Manager, UM Operations Strategy – Implementation

OperationsOperationsFull TimeRemoteSeniorTeam 1,001-5,000Since 30+ yearsH1B SponsorCompany SiteLinkedIn

Location

United States

Posted

5 days ago

Salary

$83K - $132.8K / year

Seniority

Senior

Bachelor Degree5 yrs expEnglish

Job Description

Manager, UM Operations Strategy – Implementation

CareSource

• The Manager, Utilization Management (UM) Strategy & Implementation leads a dedicated team that supports the UM program through multiple functions with a focus on all regulatory and compliance functions. • Oversee and manage UM Operations oversight functions such as Corrective Action Plan (CAP) management, ongoing monitoring, and multiple audit activities. • Build and leverage effective cross-functional business relationships and influence action across multiple internal and external partners to support a culture of compliance. • Responsible for development and maintenance of documentation related to policy, workflow and process when applicable. • Identify process gaps and drive improvements towards UM compliance in all areas.

Job Requirements

  • Bachelor’s Degree in nursing or related field is required
  • Master’s Degree in Business or health care field preferred
  • Minimum of five (5) years clinical or related healthcare industry experience is required
  • Prior leadership experience is required
  • Managed Care experience is required
  • Experience with analysis, data and reporting is required
  • Accreditation, auditing, and process improvement experience is preferred
  • Demonstrated change management and continuous improvement leadership skills are strongly desired

Benefits

  • Bonus tied to company and individual performance
  • Total rewards package
  • Comprehensive well-being support

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