Manager, Utilization Management

Are you passionate about making a difference in people's lives and improving healthcare outcomes? Look no further! Humana is seeking a highly motivated and experienced Manager for our Utilization Management department. In this role, you will have the opportunity to lead and develop a team of utilization management professionals to ensure quality, cost-effective care for our members. If you have a strong background in healthcare management, a drive for innovation, and a commitment to delivering exceptional results, we want to hear from you!

1. Develop and implement strategies to improve healthcare outcomes and ensure cost-effective care for members.
2. Lead and manage a team of utilization management professionals, providing guidance, training, and support.
3. Monitor and assess team performance, identifying areas for improvement and implementing corrective actions as needed.
4. Collaborate with other departments and stakeholders to develop and implement quality improvement initiatives.
5. Stay current on industry trends and best practices in utilization management, incorporating them into department operations.
6. Develop and maintain relationships with healthcare providers, advocating for members and negotiating cost-effective care.
7. Oversee the utilization management process, ensuring timely and accurate review of medical services and procedures.
8. Analyze data and metrics to identify areas for improvement and develop action plans to address them.
9. Collaborate with cross-functional teams to streamline processes and improve efficiency.
10. Maintain compliance with all relevant healthcare regulations and guidelines.
11. Communicate and collaborate effectively with internal and external stakeholders, including members, providers, and other healthcare professionals.
12. Manage department budget and resources effectively.
13. Stay abreast of changes and updates in healthcare policies and regulations, and communicate them to the team.
14. Foster a positive and inclusive work environment, promoting teamwork and professional growth.
15. Represent the organization in a professional and positive manner at all times.

According to JobzMall, the average salary range for a Manager, Utilization Management in Louisville, KY, USA is $80,000-$100,000 per year. However, this can vary depending on factors such as experience, education, and the specific industry or company the manager is working in. Additionally, bonuses and other forms of compensation may also affect the overall salary range.

Humana Inc. is a for-profit American health insurance company based in Louisville, Kentucky. Its strategy integrates care delivery, the member experience, and clinical and consumer insights to encourage engagement, behavior change, proactive clinical outreach and wellness for the millions of people they serve across the country. The company operates its business through the following segments: Retail, Group, and Healthcare Services.