Manager of Utilization Management II

Manager Of Utilization Management II

This role requires associates to work from the posted locations full-time, enabling consistent face-to-face collaboration, teamwork, and direct engagement. This policy promotes an environment built on in-person interaction, communication, and immediate support.

Please note that per our policy on hybrid / virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law.

This position requires travel to the Washington, D.C. office 4 days each week. The office is located at 609 H. Street NE.

The Manager of Utilization Management is responsible for managing a team of physical health practitioners in the development, implementation, and coordination of a comprehensive integrated Medical Management program designed to manage health outcomes in a highly complex member populations with varying degrees of medical complexity and acuity.

Primary duties may include but are not limited to :

• Engages in the development and implementation of integrated medical management programs across the different member population types covered by the health plan.
• Ensures continued compliance with specific medical management standards.
• Engages in the development process for medical and clinical management policy, procedures, and strategies.
• Ensures program deliverables and compliance to regulatory and accreditation standards by monitoring established goals and implementing improvement strategies.
• Hires, trains, coaches, counsels, and evaluates performance of both UM
• Assists and provides back up coverage to Case Management team

Minimum Requirements :

Preferred Qualifications :

For candidates working in person or virtually in the below location(s), the salary range for this specific position is $115,092 to $172,638.

Locations : District of Columbia (Washington, DC)

In addition to your salary, Elevance Health offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). The salary offered for this specific position is based on a number of legitimate, non-discriminatory factors set by the Company. The Company is fully committed to ensuring equal pay opportunities for equal work regardless of gender, race, or any other category protected by federal, state, and local pay equity laws.