Assists the Manager, Care Management-Precertification with performing duties to oversee day-to-day activities within the Care Management-Precertification Department to facilitate the achievement of business goals and targets. Support management with leading Precertification team to ensure all types of precertification cases are completed in compliance with State, Federal, accreditation standards and other applicable regulations.
- Assist with the development and review of l key workflows, policies and procedures and job aids at least annually. Under the direction of the Manager, Care Management-Precertification updates/revises workflows, policies and procedures and job aids as needed.
- Assist with assigning work queues and oversight for key performance indicators
- Oversee day-to-day activities, including inventory management to meet departmental and corporate timeliness standards
- Assist with improving the quality, quantity and timeliness standards to achieve individual and department performance goals as defined within the department guidelines and required by State, Federal and other accrediting organizations
- Maintain a thorough knowledge of evidence-based criteria and other policies
- Assist with the validation and confirmation of follow through of the medical review decisions.
- Assist with the development, execution and evaluation of desk level procedures and job aids
- Assist with the reviewing, updating and accurate documentation, computer files, policies and procedures related to the departmental goals and objectives.
- Assist with maintaining all standards in consideration of State, Federal, BCBSAZ and other accreditation requirements
- Assist with the implementation of quality assurance process, procedures, and measure for team activities.
- Assist with providing motivation and encouragement to team.
- Assist with interviews and candidate selection
- This position requires a full-time work schedule
- Performs all other duties as assigned
- Assist leadership with deployment of strategic initiatives and Perceptyx plan.
BCBSAZ does not discriminate in hiring or employment on the basis of race, ethnicity, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, protected veteran status or any other protected group.