Manager of Utilization Management Compliance and Operations; reside in​/WA

Job Summary

Serves as the lead subject matter expert for regulations. Oversees and provides consultation for the interpretations and interaction of current regulatory policies and requirements in preparation for surveys. Serves as the liaison between applicable government, regulatory, and key stakeholders and conducts facilitation of on‑site visits and evaluations. Performs site visits in accordance with criteria to ensure survey readiness. Manages team to ensure the completion of surveys.

Facilitates educational forums and conducts routine audits and mock surveys to aid in preparedness, tracking, trending, and facilitation of corrective action plans. Collaborates with others to complete annual reporting. Ensures licensing and accreditation by ensuring accurate reviews of requirements for new, expanding, and existing facilities/services in relation to relevant accrediting standards, evaluating relevant risk and impact. Consults with departments to ensure certification and conducts intricate and complex gap analyses.

Serves as the subject matter expert by maintaining and facilitating awareness of internal policies and consulting on the interpretation and interaction of current policies, and how they interact with the current climate, and potential changes to regulations and legislation. Serves on committees or leading projects to develop guidelines to meet compliance. Empowering others to enact data entry and analysis. Reviews data, drafts action plans, and removes barriers to enable implementation of action plans.

• Provides developmental opportunities for others; builds collaborative, cross‑functional relationships. Solicits and acts on performance feedback; works closely with employees to set goals and provide open feedback and coaching to drive performance improvement. Pursues professional growth; develops and provides training and development to talent for growth opportunities; supports execution of performance management guidelines and expectations. Leads, adapts, implements, and stays up to date with organizational change, challenges, feedback, best practices, processes, and industry trends.
  
  Fosters open dialogue amongst team members, engages, motivates, and promotes collaboration within and across teams. Delegates tasks and decisions as appropriate; provides appropriate support, guidance, and scope; encourages development and consideration of options in decision making.
• Manages designated work unit or team by translating business plans into tactical action items; oversees the completion of work assignments and identifies opportunities for improvement; ensures all policies and procedures are followed. Aligns team efforts; builds accountability for and measuring progress in achieving results; determines and ensures processes and methodologies are implemented; resolves escalated issues as appropriate; sets standards and measures progress.
  
  Fosters the development of work plans to meet business priorities and deadlines; obtains and distributes resources. Removes obstacles that impact performance; identifies and addresses improvement opportunities; guides performance and develops contingency plans accordingly; influences teams to execute in alignment with operational objectives.
• Serves as the subject matter expert for regulations for within assigned teams, departments, and facilities by: providing consultation on the interpretation and interaction of current policies, and how they interact with the current climate, and potential changes to regulations and legislation; serving on committees and leading projects to influence decisions on the enforcement and development of policies or procedures for regulations and auditing processes;
  
  initiating the development of, evaluating, and delivering educational programs to align organizational policies and procedures with regulatory requirements for leadership; and empowering team members to anticipate issues and weigh practical and technical considerations in addressing issues and coordinate with the appropriate stakeholders to develop resolutions.
• Manages data management and reporting by: empowering others to enter and store…