Utilization Management Supervisor

This is a fully remote position, open to applicants in United States.

📋 Description

• Supervise the UM nursing team in the daily operations of the department.

• Oversee and modify work queues as necessary to ensure a balanced workflow.

• Monitor and enforce compliance with departmental and organizational metrics.

• Train new employees and offer ongoing clinical training.

• Provide support to the clinical nursing team and the company program.

• Evaluate the UM program for potential enhancements in efficiency and outcomes.

• Report directly to the Director of Utilization Management.

• Collaborate closely with management personnel.

• Foster and advocate for a culture and work environment centered on ongoing, active improvement of products and services.

• Uphold ProgenyHealth's mission to enhance health outcomes for infants in intensive care nurseries through collaboration, care facilitation, continuous quality improvement, and a commitment to excellence.

⛳️ Requirements

• A current, unrestricted Registered Nurse (RN) license is mandatory.

• A minimum of two years of experience in Managed Care, specifically in a Utilization Review or Case Management capacity, is required.

• Previous experience in a team lead or supervisory role managing nursing staff is preferred.

• At least three years of clinical experience as a bedside nurse in NICU/PICU/Peds/ICU is required.

• Availability to work late as needed to oversee staff and manage caseloads is essential.

• Familiarity with URAC standards is preferred.

• Demonstrated strong problem-solving abilities are necessary.

• Proven experience in utilizing tact, diplomacy, and strategic thinking when addressing issues and changes in company policies is required.

• Self-motivated individuals who are eager to learn multiple tasks are encouraged to apply.

• Strong organizational skills and the ability to prioritize tasks effectively are essential.

• Proficient computer skills and familiarity with Microsoft Office (Word, Outlook, etc.) are required.

• Attention to detail in spelling and documentation is a must.

• A commitment to excellence in customer service is essential.

🏝️ Benefits

• Paid Time Off

• Paid Parental Leave

• Medical, dental, and vision benefits

• 401K with company match

• Short- and Long-Term Disability

• Group Life Insurance

• Tuition reimbursement

• Professional development opportunities

• Business Casual work environment