As a clinical professional on our Medical Management/Health Services team, you will supervise Prior Authorization, Concurrent Review, and/or Retrospective Review Clinical Review team to ensure appropriate care to members. You will also monitor and track UM resources to ensure adherence to performance, compliance, quality, and efficiency standards.
Requirements
- Prior experience in utilization management, including prior authorization and concurrent review
- Previous leadership or supervisory experience
- Knowledge of LTSS programs
- Compact RN license
- Standard business hours, Monday through Friday, 8:00 AM–5:00 PM, with potential for weekend, holiday, and on-call coverage
Benefits
- Competitive pay
- Health insurance
- 401K
- Stock purchase plans
- Tuition reimbursement
- Paid time off plus holidays
- Flexible approach to work with remote, hybrid, field or office work schedules
