As a Supervisor of Health Management - Utilization Review, you will be responsible for providing ongoing education, training, and guidance, as well as generating reports and ensuring appropriate contract metrics.
Hybrid Schedule: This role will report to the Columbia, MD office two days per week.
\n Essential FunctionsSupervises day to day operation of staff to ensure compliance with program protocols, state requirements and URAC accreditation standards as applicable. Ensures the operations of the contract/program are completed in a timely and satisfactory manner.Selects, develops, and manages employees to achieve individual, team, and organizational success. Ensures employee accountability through routine observation, performance measurement, and performance feedback. Fulfills Telligen's Management Philosophy that "Managers coach, engage, and support our people to achieve results".Performs audits or quality monitoring of staff to provide feedback on strengths and opportunities for improvement.Develops training protocols for staff and patient education tools to be used for orientation and on-going education, which addresses operating protocols, URAC accreditation and/or state requirements as applicable and workflow processes.Stays abreast of health care trends and changes. RequirementsCurrent and valid RN License in MDFour year degree in business or health related field and /or equivalent training and/or experience3-5 years clinical experience requiredMinimum of 5 years' experience in leadership role or has demonstrated leadership capabilitiesUtilization management experience preferredMotivational interviewing skills preferredBecause of the nature and immediacy of the work, the ability to maintain regular and predictable attendance is essentialLong Term Care and Community Based experience preferred
\nCOMMITMENT TO SAFETY As part of our commitment to health and safety, some roles may require additional health protocols (i.e. personal protective equipment or vaccination) Who We Are: Telligen is one of the most respected population health management organizations in the country. We work with state and federal government programs, as well as employers and health plans offering clinical, analytical, and technical expertise.
Health has changed a lot through our 50-year history, but what has remained constant is that we care deeply about who we serve and what we do. Our success is built on our ability to adapt, respond to client needs, and offer innovative solutions.
Our business is our people and we're looking for talented individuals who not only believe in our mission but who are ready to take ownership and make a difference in the lives of people, in the world of health. Learn more about who we are and what we do at www.telligen.com/about-us Are you Ready? We're on a mission to transform lives and economies by improving health and getting there means following through on our values of Ownership, Community, Ingenuity & Integrity.
Ownership: As a 100% employee-owned company, our employee-owners drive our business, our solutions, and share in our success. When employee-owners grow and thrive, we all win.
Community: Putting others first and being a good corporate partner wherever we work, and play makes us who we are. We Show Up. For our clients, for our communities, and for each other.
Ingenuity: We're a team of passionate professionals driven by hard work and big ideas. We understand that high-value breakthroughs come from taking calculated risks. If it will benefit our clients and advance our mission, we're all ears. We celebrate free-thinking and challenge the status quo, so brainstorm away!
Integrity: Smiling faces (virtual or in-person) are the norm around here. We enjoy a friendly work environment where everyone is dedicated to mutual trust, respect, and excellence.
Thank you for your interest in Telligen! Follow us on Twitter, Facebook, and LinkedIn to learn more about our mission-driven culture and stay up to speed.
Telligen and our affiliates are Affirmative Action, Equal Opportunity Employers (EOE/M/F/Vet/Disability), and E-Verify Participants. Telligen will not provide sponsorship for this position. If you will require sponsorship for work authorization now or in the future, we cannot consider your application at this time. Telligen does not accept 3rd party solicitations from outside staffing firms.