Utilization management supervisors usually works on a number of tasks throughout the day. Their typical setting is in an office that is usually part of a medical service provider. Usually they work a nine to five shift with heavy emphasis on clerical duties. Their main task is to review cases related to healthcare management and determine which appropriate level of response is warranted. Some cases get rejected, while other cases get sent to the next level of protocol. For this reason, the supervisors will be interacting with a wide array of clients and coworkers.
Their daily tasks may be varied, but for the most part, they will be spending many hours looking over files that their subordinates have submitted. Once these files are processed, the supervisors will determine how they want to proceed. It is a mental job that requires a great deal of skills. The most important skill is organization. Candidates must be able to juggle a number of tasks at the same time. They do not have time to search for files all over the building. They must also have good communication skills. They must be able to clearly articulate why a case has been rejected so that similar situations will not happen in the future.
The education requirements vary, but candidates are encouraged to have a degree in a related field. Related work experience is almost certainly needed, especially experience that takes place in a clinical setting.
Utilization Management (UM) Supervisor Tasks
Supervise daily utilization management functions and give administrative direction.
Review and audit patient case data to ensure quality care and cost effectiveness.
Counsel physicians in questions and concerns regarding patient quality complaints.
Ensure adherence to departmental policies and procedures.
Ensure services are in compliance with professional standards, state and federal regulatory requirements.