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Senior Manager Intake Call Center WellMed San Antonio TX

Company: UnitedHealth Group
Location: El Paso
Posted on: February 16, 2020

Job Description:

Do you have compassion and a passion to help others? Transforming healthcare and millions of lives as a result starts with the values you embrace and the passion you bring to achieve your lifes best work.(sm)The Sr. Manager , Intake is responsible for ensuring the Intake Call Center meets all business targets by providing first contact customer service to providers and members calling for Utilization Management needs. Responsible for planning, organizing, and directing the ancillary support for the Utilization Management team. The Manager coordinates team coverage for the call center teams taking calls for Prior Authorization / Hospital Intake, Specialty Drug Review and Concurrent and Peer to Peer review. The manager will ensure compliance with regulatory, contractual and accreditation requirements for the call center staff. The success of this position requires the ability to manage a large staff in a fast paced call center environment, foster communication and teamwork among the call center teams, physicians, medical management staff, corporate departments, vendors, and senior leadership.Primary responsibilities:

  • Monitors call center operations ensuring that the overall performance of the department along with individual groups, adheres to corporate and regulatory standards
  • Oversees call center departmental functions, and coordinates workflows, policies and procedures with Prior Authorization clinical team to ensure that all Federal and State regulations and contractual agreements are followed
  • Actively manages offshore vendor team to meet all program requirements, while working to solve problems, and coordinate with other groups as needed
  • Oversees the implementation of processes and system enhancements which will improve the overall quality and service provided by the UM call center teams
  • Analyzes trends and identifies/implements departmental initiatives based upon data provided through the reporting of production, quality, financial and audit data, including vendor data
  • Provides input into and supports all applicable employee and other training programs for the department staff to ensure that regulatory compliance requirements are disseminated and understood
  • Oversees the recruiting, performance, development and mentoring of service staff.
  • Initiates cross functional/departmental discussions and initiatives to remove barriers and improve communications and work flows
  • Identifies/initiates technology solutions to improve employee productivity and quality
  • Actively participates in the management of the annual departmental budget. Actively participates in the development of policies and procedures
  • Performs all other related duties as assignedYoull be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.Required Qualifications:
    • Bachelors Degree in Nursing, Business Administration, Health Care Administration or related field (Four additional years of comparable work experience beyond the required years of experience may be substituted in lieu of a bachelors degree)
    • Three years of experience at a manager level in a multi-skilled, higher volume call center environment is required, preferably within a managed care organization
    • Five years of call center management in a fast paced healthcare or other environment may be considered in lieu of managed care
    • Familiarity with call center tools such as IEX or other scheduling/forecasting software
    • Knowledge of ACD systems such as Avaya, Cisco, Genesys, Rockwell or other ACD platforms utilized in a multi-skilled high volume call center environment
    • Knowledge of regulatory and accrediting standards relating to medical management and managed care
    • Knowledge of medical terminology and claims processing
    • Knowledge of fiscal management and human resource management techniques
    • Ability to plan, supervise and review the work of non-clinical staff
    • Requires working under stressful conditions or working irregular hoursCareers with WellMed. Our focus is simple. We're innovators in preventative health care, striving to change the face of health care for seniors. We're impacting 350,000+ lives, primarily Medicare eligible seniors in Texas and Florida, through primary and multi - specialty clinics, and contracted medical management services. We've joined Optum, part of the UnitedHealth Group family of companies, and our mission is to help the sick become well and to help patients understand and control their health in a lifelong effort at wellness. Our providers and staff are selected for their dedication and focus on preventative, proactive care. For you, that means one incredible team and a singular opportunity to 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: WellMed, Healthcare, Bilingual, Call Center, Management, Medicare, CMS, Managed Care, San Antonio, New Braunfels, Seguin, Gonzales, Shiner, Yoakum, Boerne, Floresville, Helotes, Texas, TX

Keywords: UnitedHealth Group, El Paso , Senior Manager Intake Call Center WellMed San Antonio TX, Executive , El Paso, Texas

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