Verified Job
Work from home
Manager I, GBD Special Programs (UM), VA
Work from home
#59638
Remote / WFH
remotepromsp
Job Description
Job description
JR174584 Anticipated End Date: 2025-12-09 Position Title: Manager I, GBD Special Programs (UM) Job Description: LOCATION: This is a virtual eligible role. Virginia residency is required. HOURS: General business hours, Monday through Friday. This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development. Responsible for supporting the Medicaid Medical Management team by managing and overseeing non-clinical medical management specialists to ensure utilization regulatory compliance and member service delivery. Primary duties may include, but are not limited to: • Oversees compliance with turnaround times, productivity metrics, reporting, and call times. • Supervises approximately 20 non-clinical medical management specialists. • Manages resource utilization to ensure appropriate delivery of care to members, adequate coverage for all tasks and job responsibilities. • Participates in cross-functional workgroups created to maintain and develop program. • Evaluates current processes of Special Program's support functions; recommends changes for increased efficiencies and improved outcomes. • Develops and conducts training programs for staff involved in the program. • Extracts and manipulates analytical data to present findings to relevant markets and stakeholders. • Hires, trains, coaches, counsels, and evaluates performance of direct reports. Required Qualifications • Requires a BA/BS and minimum of 5 years experience in a related field, including minimum of 1 year leadership/management experience; or any combination of education and experience, which would provide an equivalent background. Preferred Qualifications • Utilization review/utilization management experience is a must for this position. • A current unrestricted RN license issued by the Commonwealth of Virginia is very strongly preferred. • Experience monitoring associate productivity (i.e. metrics) is preferred. • Prior experience in Medicaid, FIDE, and LTSS markets is very helpful. • Your must be computer literate and be comfortable using a variety of applications, especially Word and Excel. • Strong critical thinking and organizational skills are essential for this role. Job Level: Manager Workshift: 1st Shift (United States of America) Job Family: BSP > Program/Project Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health. Who We Are Elevance Health is a health company dedicated to improving lives and communities
JR174584 Anticipated End Date: 2025-12-09 Position Title: Manager I, GBD Special Programs (UM) Job Description: LOCATION: This is a virtual eligible role. Virginia residency is required. HOURS: General business hours, Monday through Friday. This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development. Responsible for supporting the Medicaid Medical Management team by managing and overseeing non-clinical medical management specialists to ensure utilization regulatory compliance and member service delivery. Primary duties may include, but are not limited to: • Oversees compliance with turnaround times, productivity metrics, reporting, and call times. • Supervises approximately 20 non-clinical medical management specialists. • Manages resource utilization to ensure appropriate delivery of care to members, adequate coverage for all tasks and job responsibilities. • Participates in cross-functional workgroups created to maintain and develop program. • Evaluates current processes of Special Program's support functions; recommends changes for increased efficiencies and improved outcomes. • Develops and conducts training programs for staff involved in the program. • Extracts and manipulates analytical data to present findings to relevant markets and stakeholders. • Hires, trains, coaches, counsels, and evaluates performance of direct reports. Required Qualifications • Requires a BA/BS and minimum of 5 years experience in a related field, including minimum of 1 year leadership/management experience; or any combination of education and experience, which would provide an equivalent background. Preferred Qualifications • Utilization review/utilization management experience is a must for this position. • A current unrestricted RN license issued by the Commonwealth of Virginia is very strongly preferred. • Experience monitoring associate productivity (i.e. metrics) is preferred. • Prior experience in Medicaid, FIDE, and LTSS markets is very helpful. • Your must be computer literate and be comfortable using a variety of applications, especially Word and Excel. • Strong critical thinking and organizational skills are essential for this role. Job Level: Manager Workshift: 1st Shift (United States of America) Job Family: BSP > Program/Project Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health. Who We Are Elevance Health is a health company dedicated to improving lives and communities
