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 authorizations and communicate determinations to stakeholders
• Generate appeals for denied authorizations and maintain documentation in relevant tracking systems

Required Qualifications

• Postsecondary certificate, diploma, or program graduation from an accredited school of nursing, or an Associate's Degree in healthcare or a related field (Required)
• Bachelor's Degree in healthcare or a related field is preferred
• Three or more years of experience in a healthcare setting is preferred
• Prior experience in managed care, case management, utilization review, or discharge planning is preferred
• Healthcare licensure may be preferred unless required by the state of practice