State Licensed Utilization Management Supervisor

Job Summary

A company is looking for a Supervisor, Utilization Management.

Key Responsibilities

• Manage and oversee staff providing operational support and medical review for Medicare Advantage clients
• Develop and implement effective strategies for maintaining efficient and cost-effective processes
• Lead and coach employees, implementing training programs to ensure staff competence

Required Qualifications

• Bachelor's degree in Business Administration, Health Care Administration, Marketing, or a related field
• Active RN license in the state of residence
• Three to five years of experience in an insurance or managed care environment, with one year in a supervisory role
• Experience in Utilization Management and knowledge of clinical and quality improvement processes
• Subject matter expertise in Medicare Advantage and clinical operations management