Supervisor, Utilization Management

 About Us:

Our purpose is to help clients exceed their financial health goals. Across the reimbursement cycle, our scalable solutions and clinical expertise help solve programmatic needs. Enabling our teams with leading technology allows analytics to guide our solutions and keeps us accountable achieving goals. 

We build long-term careers by investing in YOU. We seek to create an environment that cultivates your professional development and personal growth, as we believe your success is our success.  

JOB SUMMARY:

CorroHealth is the partner of choice to healthcare providers in support of their Revenue Cycle challenges. We solve problems through a customized mix of services, consulting and technology that can change over time to meet any client’s evolving needs.
The Supervisor of Utilization Management will lead a remote team of coordinators responsible for managing the end-to-end authorization process. This role ensures operational efficiency, compliance, and high-quality service delivery while supporting team development and performance.

ESSENTIAL DUTIES AND RESPONSIBILITIES: 
Note: The essential duties and responsibilities below are intended to describe the general duties and responsibilities of this position and are not intended to be an exhaustive statement of duties. This position may perform all or most of the primary duties listed below. Specific tasks, responsibilities or competencies may be documented in the Team Member’s performance objectives as outlined by the Team Member’s immediate Leadership Team Member.

CorroHealth is the partner of choice to healthcare providers in support of their Revenue Cycle challenges. We solve problems through a customized mix of services, consulting and technology that can change over time to meet any client’s evolving needs.

The Supervisor of Utilization Management will lead a remote team of coordinators responsible for managing the end-to-end authorization process. This role ensures operational efficiency, compliance, and high-quality service delivery while supporting team development and performance.
 

Responsibilities:

• Supervise daily operations of the Utilization Management Coordinator team.
• Monitor productivity, quality, and compliance metrics.
• Provide coaching, training, and performance feedback.
• Manage scheduling, coverage, and shift rotations.
• Manage the Authorization process end to end, from initial notification, entry and submission of required information, follow up all the way to determination and discharge.
• Maintain detailed documentation of the record in the EMR system, in the internal CorroHealth system and in the Health Payer portals.
• Verify correct eligibility and benefits for patients.
• Act as a liaison between the hospital staff and the Health Payer to facilitate information sharing and successful process completion within allocated timeframe.
• Review timely filing guidelines regarding the utilization management process.
• Track and follow up with payers on pending authorizations to ensure timely responses.
• Contact payer to elicit further information regarding status, decisions and remove hurdles in the processing.
• Identify and escalate issues that may result in delays or denials.
• Manage assigned workload of accounts through timely follow up and accurate record keeping.
• Maintain compliance with HIPAA and other healthcare regulations.
• Analyze team performance and identify areas for process improvement.
• Prepare reports for leadership on team metrics and outcomes.

Minimum Qualifications:

• High School Diploma or equivalent. Associate degree in healthcare administration or equivalent preferred.
• 4 years of experience in hospital related billing/follow-up/healthcare setting/authorization field.
• Knowledge of/experience working with managed care contracts.
• Prior experience in a supervisory or team lead role preferred.
• Experience working with customer support/client issue resolution management.
• Strong understanding of medical terminology and insurance processes.
• Experience working in EMR systems, Epic preferred.
• Excellent communication and organization skills.
• Strong multi-tasking skills, working in a face paced environment.
• Proficiency with MS Office and web systems.

Education/Experience Required: 

• High School Diploma or equivalent required
• Bachelor’s degree preferred or work equivalent.
• At least 1 year experience in either a supervisor, team lead or senior level coordinator role.
• Experience working in Peer-to-Peer or Prior Authorization departments is required.
• Highly Proficient in MS Outlook, Word, and Excel
• Must be able to create spreadsheets, use formulas such as adding, subtracting, and multiplying. Must be able to create a pivot table and do VLOOKUP.
• Accurate keyboard skills. Need to be able to type a minimum of 30wpm at a 90% accuracy.
• Demonstrated ability to present and communicate ideas clearly via email.
• Excellent time management, organizational, and prioritization skills
• Ability to balance multiple priorities.

PHYSICAL DEMANDS:
Note: Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions as described. Regular eye-hand coordination and manual dexterity is required to operate office equipment. The ability to perform work at a computer terminal for 6-8 hours a day and function in an environment with constant interruptions is required. At times, Team Members are subject to sitting for prolonged periods. Infrequently, Team Member must be able to lift and move material weighing up to 20 lbs. Team Member may experience elevated levels of stress during periods of increased activity and with work entailing multiple deadlines.
A job description is only intended as a guideline and is only part of the Team Member’s function. The company has reviewed this job description to ensure that the essential functions and basic duties have been included. It is not intended to be construed as an exhaustive list of all functions, responsibilities, skills and abilities. Additional functions and requirements may be assigned by supervisors as deemed appropriate.