BCBSAZ

BCBSAZ

Supervisor, Utilization Review (TOC) - Hybrid

AZ Blue Phoenix, AZ 85021 · Full-time

Sponsorship not specifiedDetected 30 days ago
StatisticsExcelCustomer SupportLeadershipCommunication

About the role

  • Our positions are classified as hybrid, onsite or remote.
  • This position is hybrid within the state of AZ only.
  • This hybrid work opportunity requires residency, and work to be performed, within the State of Arizona.

Responsibilities

  • Manage day to day activity of assigned team. Directly supervises staff including participating in hiring, monitoring and evaluating performance, timecards, staff training.
  • Perform all other duties as assigned

Requirements

  • 2 years of direct clinical experience
  • 1 year of experience in utilization review
  • Associate's Degree in general field of study
  • Required Work Experience
  • Required Licenses
  • Required Certifications
  • Required Education
  • Active, current, and unrestricted license to practice in the State of Arizona as a Registered Nurse (RN)
  • 1 year of managed care/health plan experience
  • Preferred Education

Nice to have

  • 1 year of Medicaid and Medicare experience
  • Bachelor's Degree in Nursing or related field of study
  • Preferred Work Experience
  • Preferred Licenses
  • Preferred Certifications
  • Ensures inpatient authorization requests are completed accurately, thoroughly, and in a timely fashion to meet contractual requirements and ensures all reviews are conducted using InterQual.
  • Evaluating statistics on department's volumes, results, including approvals, denials, turnaround times for department and individual staff.
  • Preparing and delivering reports to department and management staff.

Skills

  • Required Professional Competencies
  • Required Leadership Experience and Competencies
  • oral and written
  • Preferred Job Skills
  • Preferred Professional Competencies
  • Preferred Leadership Experience and Competencies
  • Our Commitment
  • For more information on our company, see azblue.com.
  • If interested in this position, please apply.

Benefits

  • Awarded a Healthiest Employer, Blue Cross Blue Shield of Arizona aims to fulfill its mission to inspire health and make it easy.

Company info

  • At AZ Blue, we have a hybrid workforce strategy, called Workability, that offers flexibility with how and where employees work.

This listing is sourced directly from BCBSAZ's careers page and normalized into a canonical job model.