CATEGORY: Provider Relations
REQUISITION NUMBER: UTILI001254
LOCATION: Seattle, WA 98109, USA
Post
Utilization Management Program Manager
Job Category: Provider RelationsRequisition Number: UTILI001254Apply nowPosting Details
- Posted: April 12, 2024
- Full-Time
Locations
Showing 1 location
Seattle
400 Fairview Ave N
Suite 800
Seattle, WA 98109, USA
Seattle
400 Fairview Ave N
Suite 800
Seattle, WA 98109, USA
Spokane
611 N. Iron Bridge Way
Suite 200
Spokane, WA 99202, USA
Spokane
611 N. Iron Bridge Way
Suite 200
Spokane, WA 99202, USA
Colville
720 South Washington Street
Colville, WA 99114, USA
Colville
720 South Washington Street
Colville, WA 99114, USA
+2 more locationsless locations
Job Details
Description
We are seeking a Program Manager to lead our Utilization Management and fraud, waste, and abuse programs. This position will strategically implement, and lead initiatives aimed at optimizing patient care quality and cost efficiency by helping to define the vision, translating ideas into strategy, and managing long-term program roadmaps.
At Delta Dental of Washington our vision is that all people can enjoy good oral and overall health, with no one left behind. We succeed because of a shared commitment to a set of values that guide everything we do – for our customers, for our communities, and for each other. We are Accountable. We lean in with Courage. We stay Curious. We are Inclusive. We act with Integrity.
We offer a highly competitive medical, dental and vision plans as well offering an 8% 401k match and all employees start accruing vacation and sick time from their very first day. We empower employee development through our tuition reimbursement plan, professional development plans, and employee-led communities.
The pay range for this position In Western Washington varies between $95,160.00 – $135,420.00, and for Eastern Washington varies between $76,830.00 - $109,335.00. Washington Dental Service and its affiliates, including Delta Dental of Washington and Arcora Foundation intends to offer the selected candidate a base pay within this range, dependent on job-related, non-discriminatory factors such as experience. Base pay will also be adjusted based on the candidate's geographic location.
Essential Responsibilities include the following: The list of responsibilities listed is not intended to be comprehensive. Washington Dental Service and its affiliates, including Delta Dental of Washington and Arcora Foundation reserve the right to change the responsibilities at any time with or without notice.
- Evaluate current utilization management practices and build innovative strategies to maintain quality care while ensuring cost efficiency.
- Lead the planning, initiation, execution, monitoring, control, and closure of complex, multi-faceted programs, and projects.
- Identify trends, patterns, and opportunities for improvement in program strategy and resource utilization.
- Seek and implement innovative process improvement solutions, gather, interpret, and apply data to develop actionable steps that will improve processes and optimize results.
- Facilitate cross-functional team meetings, track progress against program goals, and communicate status to stakeholders and senior management.
- Develop and implement program management methodologies and tools that promote efficiency, collaboration, and accountability.
- Facilitate change management processes associated with the program.
- Ensure compliance with relevant regulations and organizational policies.
- Ensure comprehensive documentation of technical specifications, requirements, organized records of technical decisions and changes.
- Lead and coach direct report(s) on job performance and competencies. Ensure appropriate steps are taken in their development.
Experience, skills, and education do you need to have to succeed in the position:
- Bachelor’s degree in health science (B.Sc.), business, health care administration, or a related field.
- At least 5 years of relevant experience in program management
- Health care, insurance, or working in a regulated industry experience.
- Proficiency with all phases of project management, including issues and risk identification and management, tracking dependencies, achievements and budget, and communication of overall project status.
- Experience in applying technology to improve business outcomes.
- Analytical thinking and problem-solving abilities.
Washington Dental Service and its affiliates, including Delta Dental of Washington and Arcora Foundation is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or protected veteran status.
Qualifications
Skills
Behaviors
:Motivations
:Education
Experience
Licenses & Certifications
Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities
The contractor will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor’s legal duty to furnish information. 41 CFR 60-1.35(c)
PI239536673