Supervisor, Utilization Management

V\u00e1lenz Health is a platform that simplifies healthcare, and we are looking for a Supervisor of Utilization Management to lead a team of utilization review nurses. The ideal candidate will have experience in utilization management, quality improvement, and clinical expertise. They will be responsible for guiding the team, collaborating with leadership, and ensuring timely and accurate work.

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