UM Supervisor
NAMM North America Medical Management - Redlands, CA

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To supervise, direct, train, plan, staff, and prioritize workflow for UM Technicians, Case Managers and Administrative Assistant in the IPA Medical Management Units. This position will also be responsible for generating hospital bed day census, daily bed day rounds, management of referral turn around times, and new staff training. This position will have day-to-day interactions with NAMM Operations, IPA management staff including the Medical Directors, other IPA’s, hospitalists, vendors, hospitals and physician groups.

Responsibilities:

Referral Management responsibilities and functions include:
  • Supervises daily management of TAT for Case Management and UM Technician staff in collaboration with the Lead UM Technician.
  • Supervises daily management of the error reports for Case Management and UM Technician staff in collaboration with the Lead UM Technician.
  • Assists with the training, development, and mentoring of new referral management staff
Case Management responsibilities and functions include:
  • Supervises daily management of acute, SNF, and Rehab admissions for the IPA.
  • Leads team in daily bed day rounds.
  • Provides current census to bed day data collection unit on a daily basis
  • Assists with the training of new staff on site at local network facilities.

Qualifications:
  • RN or LVN license required. CCM certification preferred.
  • Two (2) to five (5) years managed care/IPA experience.
  • Solid knowledge of general IPA operations.
  • Solid experience using Interqual or Milliman guidelines.
  • Computer skills using Outlook and other Microsoft Office products.

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