RN Post-Acute UM Supervisor

Job Summary

Overseeing utilization management activities in post-acute settings, the full-time RN Post-Acute UM Supervisor will manage a team, implement workflow refinements, and collaborate with clinical leadership to enhance AI-enabled processes, all while working remotely.

Key responsibilities

• Supervise the Post-Acute UM team, including hiring, training, and performance management
• Monitor key UM and operational metrics to identify patterns and drive performance improvement
• Lead quality audits and ensure compliance with regulatory and health plan standards

Required qualifications

• Active unrestricted RN license with a minimum of 4 years of clinical experience
• At least 3 years of utilization management experience within a health plan or managed care setting
• 1-2 years of supervisory or team lead experience
• Working understanding of AI/LLM tools in clinical or UM workflows
• Knowledge of InterQual criteria and CMS regulations