Description:
GENERAL SUMMARY
Responsible for the management, coordination and implementation of a broad range of projects and programs in direct support of the Utilization Management team, as well as the day-to-day management of service or business units to meet or exceed provider service requirements and business objectives.
ESSENTIAL RESPONSIBILITIES
- At the direction of the Utilization Management team, assumes responsibility for programs and projects through the analysis, implementation, and evaluation phases. May directly manage/coordinate projects after implementation or may delegate that responsibility to other persons as appropriate. Performs data analysis and develops summaries and/or recommendations on programs and projects for the UM team.
- Builds and administers a business plan to meet or exceed goals.
- Coordinates resources (financial, capital, human, etc.) to ensure that programs and projects have sufficient means to meet/exceed expectations.
- Analyzes daily, weekly, and monthly statistical reports and makes appropriate recommendations/forecasts regarding call volume and staff schedules. Provides accurate and pertinent data to Director/Vice President for use in strategic and tactical planning.
- Provides input into development of the UM budget; manages budget and controls expense while meeting operations, financial and service requirements.
- Resolves member, provider, and staff complaints, issues, and concerns. Serves as the focal point for all issues relative to the team’s customers; fosters collaborative relationships with internal and external customers.
- Recruits, develops, and motivates staff. Initiates and communicates a variety of personnel actions including employment, termination, performance reviews, salary reviews, and disciplinary actions.
- Rewards employees based on the development and utilization of required skills and competencies that contribute to the achievement of business objectives.
- Maintains a positive work environment and structure that supports self-directed teams and optimizes the experience, skill, knowledge and capability of the team.
- Performs other duties as required.
Qualifications:
JOB SPECIFICATIONS
- Bachelor’s degree or equivalent experience.
- Significant experience in health care, (usually 6 - 7 years) with management responsibility. Experience in managing cross-functional, self-directed teams preferred.
- Management of inbound customer service call centers preferred.
- Knowledge of queuing theories, work force scheduling, and telecommunications.
- Demonstrated leadership and motivation skills.
- Ability to initiate and drive change; demonstrated results-driven approach.
- Demonstrated process and project management ability.
- Ability to develop and implement service strategies for internal and external customers.
Coventry Health Care is an Affirmative Action/Equal Opportunity Employer, and we are committed to building a talented and diverse team.
Job: First/Mid Level Officials and Managers
Primary Location: Louisville, KY, US
Other Locations: ,
Organization: 38500 - Coventry Health & Life-KY
Schedule: Full-time
Job Posting: 2013-05-23 00:00:00.0
Job ID: 1311823
GENERAL SUMMARY
Responsible for the management, coordination and implementation of a broad range of projects and programs in direct support of the Utilization Management team, as well as the day-to-day management of service or business units to meet or exceed provider service requirements and business objectives.
ESSENTIAL RESPONSIBILITIES
- At the direction of the Utilization Management team, assumes responsibility for programs and projects through the analysis, implementation, and evaluation phases. May directly manage/coordinate projects after implementation or may delegate that responsibility to other persons as appropriate. Performs data analysis and develops summaries and/or recommendations on programs and projects for the UM team.
- Builds and administers a business plan to meet or exceed goals.
- Coordinates resources (financial, capital, human, etc.) to ensure that programs and projects have sufficient means to meet/exceed expectations.
- Analyzes daily, weekly, and monthly statistical reports and makes appropriate recommendations/forecasts regarding call volume and staff schedules. Provides accurate and pertinent data to Director/Vice President for use in strategic and tactical planning.
- Provides input into development of the UM budget; manages budget and controls expense while meeting operations, financial and service requirements.
- Resolves member, provider, and staff complaints, issues, and concerns. Serves as the focal point for all issues relative to the team’s customers; fosters collaborative relationships with internal and external customers.
- Recruits, develops, and motivates staff. Initiates and communicates a variety of personnel actions including employment, termination, performance reviews, salary reviews, and disciplinary actions.
- Rewards employees based on the development and utilization of required skills and competencies that contribute to the achievement of business objectives.
- Maintains a positive work environment and structure that supports self-directed teams and optimizes the experience, skill, knowledge and capability of the team.
- Performs other duties as required.
Qualifications:
JOB SPECIFICATIONS
- Bachelor’s degree or equivalent experience.
- Significant experience in health care, (usually 6 - 7 years) with management responsibility. Experience in managing cross-functional, self-directed teams preferred.
- Management of inbound customer service call centers preferred.
- Knowledge of queuing theories, work force scheduling, and telecommunications.
- Demonstrated leadership and motivation skills.
- Ability to initiate and drive change; demonstrated results-driven approach.
- Demonstrated process and project management ability.
- Ability to develop and implement service strategies for internal and external customers.
Coventry Health Care is an Affirmative Action/Equal Opportunity Employer, and we are committed to building a talented and diverse team.
Job: First/Mid Level Officials and Managers
Primary Location: Louisville, KY, US
Other Locations: ,
Organization: 38500 - Coventry Health & Life-KY
Schedule: Full-time
Job Posting: 2013-05-23 00:00:00.0
Job ID: 1311823