Washington State Licensed UM Manager

Job Summary

A company is looking for a Manager of UM Ops & Analytics.

Key Responsibilities

• Spearhead the development and evaluation of Appeals team metrics to drive continuous process improvement
• Direct UM clinical and non-clinical audits and manage large-scale projects to ensure compliance with standards
• Conduct monitoring and analysis of utilization data, providing actionable insights to stakeholders

Required Qualifications, Training, and Education

• Bachelor's degree in management or a healthcare-related field; Master's preferred
• Minimum six (6) years of experience in managed care, health systems, or state regulatory agencies
• Two (2) years of experience managing diverse staff and teams
• Knowledge of standard utilization management processes and regulatory requirements
• Strong project management skills and experience in analyzing complex data sets