Supervisor, Utilization Management

As a Supervisor of Utilization Management, you will lead a team of utilization review nurses by providing guidance, mentorship, and training to ensure timely, high-quality clinical reviews. Using your leadership and clinical expertise, you will collaborate with organizational leaders to refine utilization management policies, support adherence to evidence-based guidelines, and promote a culture of continuous improvement.

Requirements

• 5+ years of Utilization Management or Quality Improvement experience in managed care
• 2+ years of clinical experience in an acute care or surgical hospital setting
• Active RN license in the state of residence
• Proficient in ICD-10, CPT, HCPCS, Revenue codes, and CMS/URAC guidelines
• Familiar with evidence-based criteria such as MCG and health plan policies
• Strong relationship-building skills with clear, effective communication
• Able to thrive in a fast-paced, detail-oriented, deadline-driven environment

Benefits

• Generously subsidized company-sponsored Medical, Dental, and Vision insurance
• Spending account options: HSA, FSA, and DCFSA
• 401K with company match and immediate vesting
• Flexible working environment
• Generous Paid Time Off to include vacation, sick leave, and paid holidays
• Employee Assistance Program that includes professional counseling, referrals, and additional services
• Paid maternity and paternity leave
• Pet insurance
• Employee discounts on phone plans, car rentals and computers
• Community giveback opportunities, including paid time off for philanthropic endeavors