About this opportunity
IntelliResume lists this Supervisor, Utilization Management opportunity in nevada, Iowa. Review the employer’s description below for duties, qualifications and application requirements.
Job description
About This Role
The Supervisor of Utilization Management oversees the Prior Authorization, Concurrent Review, and or Retrospective Review Clinical Review team to ensure appropriate care for members. This remote role is ideal for experienced nursing professionals looking to lead a team in a dynamic healthcare environment.
Highlights
Pay: $75,300 - $135,400/year
Location: Remote, NV
Schedule: Full Time, Day shift
What You'll Do
Supervise day-to-day activities of the utilization management team.
Monitor and track UM resources to ensure adherence to performance, compliance, quality, and efficiency standards.
Collaborate with the utilization management team to resolve complex care member issues.
Maintain knowledge of regulations, accreditation standards, and industry best practices related to utilization management.
Identify opportunities for process and quality improvements within utilization management.
Educate and provide resources for the utilization management team on key initiatives.
Monitor clinical review nurses and ensure compliance with applicable guidelines, policies, and procedures.
Develop and implement UM policies, procedures, and guidelines with senior management.
Evaluate utilization management team performance and provide feedback.
Assist with onboarding, hiring, and training of team members.
Requirements
Education:
Graduate of an Accredited School of Nursing or Bachelor's degree required.
Experience:
4+ years of related experience required.
Knowledge of utilization management principles preferred.
Licenses & Certifications:
RN - Registered Nurse - State Licensure and or Compact State Licensure required.
Benefits
Competitive pay
Health insurance
401K and stock purchase plans
Tuition reimbursement
Paid time off plus holidays
Flexible work schedules
About Centene
Centene is a leading healthcare provider committed to delivering exceptional patient care. They connect people to the care they need to live healthier lives, making a real impact every day through meaningful challenges that support individuals, families, and communities.
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Worksite address
nevada, IA, 50201, US
Who can apply
Review the original listing for work authorization, qualifications and employer requirements.