BHM Healthcare Solutions
  • 06-Feb-2020 to 06-Apr-2020 (EST)
  • Tampa, FL, USA
  • $68,000 - $75,000 Annually
  • Salary
  • Full Time

Healthcare Insurance, Paid Time Off, Paid Holidays, 401k Plan


Location:  Tampa, Florida

Salary:     $68,000-$75,000 Annually.  Compensation is commensurate with level of experience.

BHM Healthcare Solutions, Inc. (BHM) is seeking an UR/UM Clinical Operations Supervisor to join our Behavioral Health and Medical Review services organization. BHM provides behavioral health and medical independent review services and performance improvement consulting to health plans, providers, ACOs, TPAs, workers' compensation, and other insurers nationally.

The ideal candidate has these key attributes:

  • Self-directed as required while able to be directed as needed.
  • Superior communication skills both verbally and written.
  • Strong ability for multi-tasking in fast paced, ever changing environment.
  • Strong analytic and organizational skills
  • Demonstrated excellent technical abilities, including proficiency with Microsoft Office software, including Word, Excel, and Outlook.
  •  

SCOPE OF ROLE & RESPONSIBILITIES

  • Perform daily oversight of IRO Operations Clinical Staff
  • Monitor staff productivity and quality and ensure adherence to regulations client requirements, and company policies
  • Accomplishes staff job results by providing constructive feedback, coaching, and disciplining when needed
  • Problem solve and develop solutions for staff to address client questions, problems
  • Provide management reports on orders processed, daily activities, and metrics
  • Responsible for staff scheduling to ensure operational coverage
  • Liaise with superior to make decisions for operational activities and set strategic goals
  • Oversight of client service level requirements, including but not limited to, phone statistics, case turnaround time and case quality measures
  • Communicate verbally and in writing to clients, management, co-workers and peer reviewers
  • Responsible for quality phone and email communications to enhance client satisfaction
  • Oversee customer support processes, initiate workflow changes based on client feedback and as deemed appropriate, and organize them to enhance customer satisfaction
  • Develop, enhance and monitor staff training to ensure quality and quantity of staff performance
  • Quality assurance of final documentation of peer reviews prior to submission to client
  • The candidate will be available after-hours and weekends for IRO operational support in rotation
  • Other duties as assigned
  •  

QUALIFICATION REQUIREMENTS

  • Minimum Education: Bachelor's Degree and Independent Licensed Clinical Professional (RN, LCSW, LMHT)
  • Must have an active clinical license.
  • Experience with processing clinical peer reviews for Utilization Management program, including utilization review of worker's compensation cases
  • Prior experience supervising staff.

For more information about BHM, visit www.bhmpc.com.

 

BHM Healthcare Solutions
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