Arizona Licensed Utilization Management Supervisor
Job Summary
Supervising a clinical review team, the full-time Arizona Licensed Utilization Management Supervisor will ensure appropriate care for members by overseeing prior authorization, concurrent review, and retrospective review processes in a remote setting.
Key responsibilities
- Monitor and track utilization management resources to ensure compliance with performance and quality standards
- Collaborate with the utilization management team to resolve complex member care issues
- Evaluate team performance and provide coaching and feedback to ensure adherence to quality standards
Required qualifications
- Graduate of an accredited nursing school or a Bachelor's degree
- 4+ years of related experience in utilization management
- Current RN licensure or compact state licensure
- Certification as a Managed Care Nurse (CMCN) within 1.5 years for Health Net Federal Services
- US citizenship and current National Agency Check government security clearance for Health Net Federal Services
Complete Job Description
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