$82,388.41 - $135,940.88 Looking for a way to make an impact and help people? Join PacificSource and help our members access quality, affordable care! PacificSource is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to status as a protected veteran or a qualified individual with a disability, or other protected status, such as race, religion, color, national origin, sex, sexual orientation, gender identity or age. Diversity and Inclusion: PacificSource values the diversity of the people we hire and serve. We are committed to creating a diverse environment and fostering a workplace in which individual differences are appreciated, respected and responded to in ways that fully develop and utilize each person's talents and strengths. Responsible for oversight of defined Health Services programs, services, and functions which may include, but not be limited to, health management, behavioral health services, care management, utilization management, grievance and appeals, claim review, and policy/procedure development. Supervises and provide guidance to direct reports and other department staff regarding company policies, procedures, and operations. Manage the quality and productivity of team responsibilities and workflow as they relate to both assigned functions and the overall effectiveness of the Health Services team. Works to resolve issues and improve processes and outcomes. Essential Responsibilities: * Fosters teamwork, manages change, encourages innovation, builds collaborative relationships, encourages involvement and initiative, and develops goal orientation in others.. * Serve as liaison with other PacificSource departments and community partners to coordinate optimal provision of service and dissemination of information including regulatory updates. Serve on various internal and external committees as required or designated. Document and report any pertinent communications back to the team or department. * Oversee and assist in providing exceptional customer service and information to members and other external and internal customers. * Provide onsite and telephonic training and support with our provider community. To include collaboration with our provider network team. * Monitor daily workflow, volumes and other work processes of team to assure appropriate distribution and processing of tasks. * Improve department performance, assist with process improvement and work with other departments. Utilize LEAN methodologies for continuous improvement. Utilize visual boards to monitor key performance indicators and identify improvement opportunities. * Utilize and promote use and training of evidence-based medical criteria. * Assist with hiring and provide ongoing supervision, development, coaching, training, evaluation, and leadership of direct reports. This may include corrective actions, annual performance reviews, and involvement in promotions and/or terminations.. * Actively participate as a key team member in weekly meetings department, team and other meetings as assigned. * Work cooperatively with department leadership and staff to ensure that work processes are well-ordered and managed appropriately. Provide backup to UM staff, other departmental teams and/or management staff, as needed. * Facilitate investigation and resolution of process-related issues as needed. Facilitate conflict resolution, including interfacing with affected departments and individuals, as appropriate. Help to troubleshoot and resolve issues related to health services, escalating when appropriate. * Maintain and develop UM documents including departmental communication materials (i.e. letters, forms, FAQs), training/educational material, SharePoint site and procedure To view the full job description,