Kentucky Licensed Utilization Manager

Job Summary

A company is looking for a Utilization Management Manager, remote.

Key Responsibilities

• Manage front-end prior authorizations and in-house concurrent review authorizations to ensure timely patient access to care
• Coordinate with clinical teams and managed care organizations to facilitate the authorization process and communicate determinations
• Document authorization information and generate written appeals for denied authorizations, ensuring compliance with regulatory timeframes

Required Qualifications

• Postsecondary certificate, diploma, or program graduation from an accredited school of nursing, or an Associate's Degree in healthcare or a related field (Required)
• Bachelor's Degree in healthcare or a related field (Preferred)
• Three or more years of experience in a healthcare setting (Preferred)
• Prior experience in managed care, case management, utilization review, or discharge planning (Preferred)
• Healthcare licensure may be preferred unless required by the state of practice (Preferred upon hire)