Oregon Licensed Utilization Manager
Job Summary
Overseeing the Utilization Management team, the full-time Oregon Licensed Utilization Manager will manage day-to-day operations, ensure compliance with regulations, and lead process improvement initiatives in a remote setting.
Key responsibilities
- Manage and supervise the Utilization Management team, ensuring compliance with Oregon Administrative Rules and contractual obligations
- Collaborate with medical directors to facilitate peer reviews and develop medical necessity policies
- Implement process improvements and monitor the effectiveness of the Utilization Management program
Required qualifications
- Bachelor's degree in Nursing or a related healthcare field
- Three or more years of experience supervising or leading teams
- Two or more years of experience in Utilization Management
- Knowledge of Medicare and Medicaid regulations
- Ability to work collaboratively across teams and with external partners
Complete Job Description
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