Ohio Licensed Utilization Management Manager

Job Summary

Managing a clinical review team, the full-time Ohio Licensed Utilization Management Manager will oversee prior authorization, concurrent review, and retrospective review processes while working remotely from Ohio and attending in-person meetings a few times per year.

Key responsibilities

• Manage the clinical review team to ensure compliance with guidelines, policies, and procedures
• Analyze utilization management activities and provide recommendations for improvement to senior leadership
• Develop and implement utilization management policies and provide training and resources to the team

Required qualifications

• Graduate of an Accredited School of Nursing or Bachelor's degree
• 5+ years of related experience in healthcare management
• 2+ years of supervisory experience preferred
• Active RN Ohio license required
• Knowledge of utilization management principles preferred