Louisiana Licensed Utilization Supervisor

Job Summary

Supervising a remote clinical review team, the full-time Louisiana Licensed Utilization Supervisor will manage prior authorization, concurrent review, and retrospective review processes to ensure appropriate care for members while collaborating on complex care issues and improving utilization management practices.

Key responsibilities

• Monitors and tracks utilization management resources for compliance with performance and quality standards
• Collaborates with the team to resolve complex member care issues and identifies opportunities for process improvements
• Provides coaching, feedback, and training to ensure adherence to guidelines and enhances team performance

Required qualifications

• Graduate of an accredited nursing school or a Bachelor's degree
• Minimum of 4 years of related experience in utilization management
• Current RN state licensure or compact state licensure is required
• Knowledge of utilization management principles is preferred