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 life's best work. (sm)

WellMed provides concierge - level medical care and service for seniors, delivered by physicians and clinic stat that understands and care about the patient's health. WellMed's proactive approach focuses on prevention and the complete coordination of care for patients. WellMed is now part of the Optum division under the greater UnitedHealth Group umbrella.

Let's talk about meaningful work, an important role and a career move that can transform your future. At WellMed, a part of OptumCare and the growing UnitedHealth Group family of businesses, we focus on prevention and the complete coordination of care for our patients. Join us and you'll be part of a team dedicated to patient-centered, safe and effective health care. Your skills and talents will make an important impact on our patients while you open doors for yourself that simply do not exist in any other organization.

 The position requires a rotating Saturday shift.

Under the supervision of the Manager of Utilization Management, the supervisor is responsible for the daily operations of the UM department. Daily coordination with  UM Nurses, UM Care Team Associates, UM management and other various Wellmed departments and staff to deliver cost effective, quality of care services to Wellmed members, in accordance with wellmed policies and processes.  Provides administrative and leadership support to staff.

Primary Responsibilities:

• Performs daily oversight of the UM platform queues to meet established performance metrics
• Oversees prior authorization inventory and regulatory timeframes
• Responsible for supervising all aspects of the UM expedited and standard requests inventory and service timeframes
• Assists with the hiring and training of new staff as needed
• Applies employee performance management techniques through job-related coaching, training and development activities
• Conducts routine audits on UM reviews to ensure adherence to CMS regulations
• Produces daily, weekly and monthly UM reports
• Conducts routine staff meetings
• Conducts provider education sessions on Wellmed UM processes
• Performs all other related duties as assigned

Required Qualifications:

• High school diploma or GED equivalent
• 3+ years of related experience with at least 2 years in a supervisory capacity
• 1+ year of managed care experience in Prior Authorization or Claims Review
• Medical terminology, ICD-9 and CPT knowledge
• Proficiency with Microsoft Office applications
• You will be asked to perform this role in an office setting, however, may be required to work from home temporarily due to space limitations.
• Employees are required to screen for symptoms using the ProtectWell mobile app, Interactive Voice Response (i.e., entering your symptoms via phone system) or a similar UnitedHealth Group-approved symptom screener prior to entering the work site each day, in order to keep our work sites safe. Employees must comply with any state and local masking orders. In addition, when in a UnitedHealth Group building, employees are expected to wear a mask in areas where physical distancing cannot be attained.

Preferred Qualifications:

• Medical Assistant (MA) certification
• Associate's Degree in a healthcare related field

• Telephonic and/or telecommute experience

Physical & Mental Requirements:

• Ability to lift up to 25 pounds
• Ability to sit for extended periods of time
• Ability to stand for extended periods of time
• Ability to use fine motor skills to operate office equipment and/or machinery
• Ability to receive and comprehend instructions verbally and/or in writing
• Ability to use logical reasoning for simple and complex problem solving

Careers 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 90,000+ 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, Supervisor, Utilization Management, UM, Medical terminology, ICD and CPT, Claims Coder, San Antonio, New Braunfels, Seguin, Gonzales, Shiner, Yoakum, Boerne, Floresville, Helotes, 75249, NW PKWY., Texas, TX