Utilization Management Manager

Job Summary

A company is looking for a Utilization Management Manager, REMOTE.

Key Responsibilities

• Manage front-end prior authorizations and in-house concurrent review authorizations to ensure timely patient access to care
• Coordinate with various teams to secure prior authorizations and communicate determinations to relevant stakeholders
• Review medical necessity assessments and generate appeals for denied authorizations

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; equivalent experience may be considered
• Experience in managed care, case management, utilization review, or discharge planning is a plus