Registered Nurse Manager, UM Operations

Job Summary

Leading a dedicated team in a full-time remote capacity, the Registered Nurse Manager, UM Operations will manage compliance and regulatory functions, oversee prior authorization processes, and implement strategies for the Utilization Management program.

Key responsibilities

• Establish compliance baselines and develop strategies to align with organizational goals
• Oversee Corrective Action Plan management and multiple audit activities to ensure ongoing compliance
• Collaborate with cross-functional teams to drive process improvements and support accreditation initiatives

Required qualifications

• Bachelor's Degree in nursing or a related field is required
• Minimum of five (5) years of clinical or related healthcare industry experience
• Prior leadership experience in a healthcare setting is required
• Managed Care experience is essential
• Experience with analysis, data, and reporting is required