New York State Licensed Utilization Manager

A company is looking for a Senior Manager of Utilization Management, responsible for overseeing high acuity teams and ensuring effective utilization management. Key Responsibilities Lead and manage the high acuity team to ensure individualized care decisions and timely interventions Build a high-performing team by regularly developing and assessing clinical, technical, and leadership skills Enforce compliance with CMS and state regulations while participating in the Quality Management Program to identify improvement opportunities Required Qualifications Associate's degree in Nursing from an accredited program New York State Registered Nurse (NYS RN) license Experience managing a team in a virtual environment Understanding of Medicare, Medicaid, and Managed Long-Term Care Plans Experience in case management for long-term care programs

Feb 19, 2025 - 16:08

A company is looking for a Senior Manager of Utilization Management, responsible for overseeing high acuity teams and ensuring effective utilization management. Key Responsibilities Lead and manage the high acuity team to ensure individualized care decisions and timely interventions Build a high-performing team by regularly developing and assessing clinical, technical, and leadership skills Enforce compliance with CMS and state regulations while participating in the Quality Management Program to identify improvement opportunities Required Qualifications Associate's degree in Nursing from an accredited program New York State Registered Nurse (NYS RN) license Experience managing a team in a virtual environment Understanding of Medicare, Medicaid, and Managed Long-Term Care Plans Experience in case management for long-term care programs