Supervisor, Utilization Review (TOC) - Hybrid

The Utilization Review Supervisor at Blue Cross Blue Shield of Arizona coordinates the Utilization Review department, focusing on medical necessity reviews and authorization processes for Medicaid members. This role monitors authorization timeliness and cost-effectiveness while overseeing the Transition of Care team to ensure members' needs are met post-discharge. The position involves staffing management, auditing case files, and ensuring compliance with regulatory and contractual requirements.