RN Utilization Management Supervisor

Job Summary

A company is looking for a UM Acute Inpatient Supervisor.

Key Responsibilities

• Supervise the Acute UM Inpatient team, including hiring, scheduling, training, performance management, coaching, and corrective action
• Monitor and act on key UM and operational metrics, identifying trends and driving continuous improvement
• Conduct audits and quality reviews, implementing education, workflow refinements, and policy updates in collaboration with medical leadership

Required Qualifications

• An unrestricted RN license with a minimum of 4 years of experience
• A minimum of 3 years experience in utilization management at a health plan
• A minimum of 1-2 years supervisory experience
• Understanding of AI/LLM and knowledge of Interqual Guidelines
• Understanding of CMS guidelines and MA requirements