Utilization Management Healthcare Operations Supervisor

About the role

The US Healthcare Operations Supervisor leads the provider‑focused support team, ensuring that authorization requests, referrals, provider communications, fax intake and utilization management activities are completed accurately and on time. This onsite position (with potential remote work after training) operates on a graveyard/shifting schedule in Makati.

Key responsibilities

• Supervise daily activities of Healthcare Operations Specialists, Prior Authorization Coordinators, Referral Coordinators and provider support staff.
• Monitor attendance, productivity, quality and schedule adherence to meet SLA targets.
• Conduct coaching sessions, performance evaluations and development planning for direct reports.
• Oversee provider‑facing operations including prior authorizations, referral coordination, eligibility inquiries and provider communications.
• Manage operational queues, workload distribution and risk mitigation to ensure compliance and client satisfaction.
• Partner with Quality Assurance, Training, Workforce Management and Operations Leadership to drive process improvements.

Required profile

• Extensive experience in US healthcare operations, especially provider support, prior authorization, utilization management and referral coordination.
• Proven leadership experience in a call‑center or similar environment.
• Strong client‑facing skills and a track record of driving performance, compliance and operational excellence.
• Non‑clinical background; no medical licensure required.

Required skills

• In‑depth knowledge of provider relations, managed care and healthcare payer processes.
• Ability to optimize workflows, manage performance metrics and ensure SLA compliance.
• Excellent mentorship, coaching and team‑building capabilities.