tango is a leader in the home health management industry and is preparing for significant growth! Our mission is to deliver innovative, home-based, post-acute solutions through proprietary technology and proven processes. We partner with health plans to provide a comprehensive suite of products and services designed to manage the total cost of care.
We are currently looking for a Supervisor, Utilization Management to join our growing team!
Position Description:
The Supervisor of Utilization Management (UM) oversees team leads and ensures the overall management of referrals to support smooth transitions of care into the home health setting. This role is responsible for team productivity, performance metrics, and effective collaboration with internal departments. The Supervisor also serves as a clinical resource and ensures that all utilization processes align with company policies, payer requirements, and quality standards.
Essential Functions:
1.Mentor and coach team members to further develop competencies.
2.Lead by example and model behaviors aligned with company values.
3.Maintain an open-door policy to encourage communication and improve staff engagement.
4.Partner with the Clinical Educator to train new staff, ensuring adherence to payer and company procedures and performance standards.
5.Collaborate with team leads to monitor, coach, and measure team performance, including productivity, quality, and attendance.
6.Serve as a clinical resource to non-clinical team members.
7. Educate direct reports on all aspects of the pre-authorization and concurrent review process.
8.Schedule and lead monthly team meetings to communicate updates, audit results, and process improvements.
9.Ensure timely and accurate processing of delegated and non-delegated home health contracts.
10.Support plan requirements related to turnaround times and compliance.
11.Manage work queues, monitor key metrics, and ensure workload distribution.
12.Collaborate with the Sr. Supervisor to plan staffing levels, monitor labor utilization, and manage overtime.
13.Participate in hiring, performance reviews, improvement plans, and disciplinary actions as directed.
14.Complete cases weekly to maintain “super-user” knowledge of processes and software.
15.Demonstrate knowledge of home health care and specialty programs in all communications with referral sources and healthcare partners.
16.Oversee workflow coordination to ensure efficient and timely operations.
17.Partner with intake, compliance, claims, network, quality, and other departments to ensure services meet regulatory and contractual requirements.
18.Ensure smooth onboarding of new payer contracts.
19.Provide excellent customer service in all communications with internal and external stakeholders.
20. Escalate administrative oversight issues related to clinical staff (RNs, PTs, OTs, SLPs, etc.) to the Sr. Supervisor as appropriate.
21.Perform other duties as assigned.
Office Location:
- Remote
Qualifications:
- Licensed clinician: RN with no restrictions.
- Ability to obtain additional state licensure as required.
- Prior home health experience preferred.
- Minimum of 10 years of clinical experience.
- Previous supervisory experience required.
- Strong ability to teach, coach, and apply adult learning techniques.
- Self-directed, motivated, and able to work independently under the Sr. Supervisors guidance.
- Strong verbal, written, and interpersonal communication skills.
- Effective problem-solving skills with ability to resolve complex issues.
- Skilled in adapting to procedural and organizational changes.
- Ability to read, analyze, and interpret technical procedures, regulatory documents, and payer contracts.
- Experience presenting to and collaborating with physicians, managers, payers, and external stakeholders.
Knowledge and Experience:
- Extensive knowledge of the post-acute continuum of care.
- Expertise in CMS Chapter 7 guidelines and Milliman criteria.
- Strong proficiency with Microsoft Office (Outlook, Word, Excel, SharePoint), Adobe, and medical management systems.
- Ability to work in a fast-paced environment and manage competing priorities.
tango provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws. tango will make reasonable accommodations for qualified individuals with known disabilities unless doing so would result in an undue hardship.