RN Utilization Management Manager

Job Summary

A company is looking for a Manager, Utilization Management.

Key Responsibilities

• Manage the prior authorization, concurrent review, and retrospective clinical review team ensuring compliance with guidelines and policies
• Analyze utilization management activities to identify areas for improvement and align with organizational goals
• Develop and maintain compliance with utilization management policies and provide coaching to the team

Required Qualifications

• Graduate of an Accredited School of Nursing or Bachelor's degree with 5+ years of related experience
• 2+ years of supervisory experience preferred
• Knowledge of utilization management principles preferred
• Prior Authorization and Medicaid experience highly preferred
• RN - Registered Nurse - State Licensure and/or Compact State Licensure required