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 streamline the authorization process and communicate determinations to stakeholders
• Generate written 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 (Preferred)
• Healthcare licensure may be preferred unless required by the state of practice (Preferred upon hire)
• Three (3) or more years of experience in a healthcare setting (Preferred)
• Prior experience in managed care, case management, utilization review, or discharge planning (Preferred)