RN Utilization Management Manager

A company is looking for a Manager, Utilization Management. Key Responsibilities Manage the prior authorization, concurrent review, and retrospective clinical review team ensuring compliance with guidelines and policies Analyze utilization management activities to identify areas for improvement and align with organizational goals Develop and maintain compliance with utilization management policies and provide coaching to the team Required Qualifications Graduate of an Accredited School of Nursing or Bachelor's degree with 5+ years of related experience 2+ years of supervisory experience preferred Knowledge of utilization management principles preferred Prior Authorization and Medicaid experience highly preferred RN - Registered Nurse - State Licensure and/or Compact State Licensure required

Apr 22, 2025 - 15:27

A company is looking for a Manager, Utilization Management. Key Responsibilities Manage the prior authorization, concurrent review, and retrospective clinical review team ensuring compliance with guidelines and policies Analyze utilization management activities to identify areas for improvement and align with organizational goals Develop and maintain compliance with utilization management policies and provide coaching to the team Required Qualifications Graduate of an Accredited School of Nursing or Bachelor's degree with 5+ years of related experience 2+ years of supervisory experience preferred Knowledge of utilization management principles preferred Prior Authorization and Medicaid experience highly preferred RN - Registered Nurse - State Licensure and/or Compact State Licensure required