Utilization Management Manager

Job Summary

A company is looking for a Utilization Management Manager, Remote PRN.

Key Responsibilities

• Manage prior authorizations and concurrent review authorizations to ensure timely patient access to care
• Coordinate with various teams to facilitate the authorization process and communicate determinations to stakeholders
• Generate appeals for denied authorizations and maintain documentation in relevant tracking systems

Required Qualifications

• Postsecondary non-Degree (Cert/Diploma/Program Grad) from an accredited School of Nursing required
• Associate's Degree in healthcare or related field required; Bachelor's Degree preferred
• 3+ years of experience in a healthcare setting strongly preferred
• Healthcare professional licensure preferred; in lieu of licensure, 3+ years of relevant experience required
• Experience in managed care, case management, utilization review, or discharge planning is a plus