Mgr Utilization Mgmt-System (Fully Remote)

Piedmont Healthcare Corporate; United States; Remote; USD 110,000 - 140,000; Full time

Job summary

Piedmont Healthcare Corporate is seeking a remote Utilization Management Manager based in Atlanta, GA. The role focuses on ensuring medical necessity criteria are applied across facilities and leading a corporate team to uphold quality and compliance in utilization management.

Qualified candidates bring RN licensure in Georgia, IQCI certification, and at least five years of acute hospital utilization experience, including two years in management.

Qualifications

• Oversee system-level oversight of utilization management activities.
• Ensure use of medical necessity criteria (InterQual and/or Milliman).
• Lead professional staff with at least two years of management experience.
• 5 years of acute hospital utilization management experience.
• Maintain current Georgia RN licensure and IQCI certification.

Responsibilities

• Oversee system-level matrix oversight of utilization management activities.
• Ensure use of medical necessity criteria (InterQual and/or Milliman).
• Manage professional staff with at least two years of management experience.

Skills

Management experience

Utilization management

Quality focus

Education

RN licensure (GA)

IQCI certification

Job description

• Oversee system-level matrix oversight of utilization management activities.
• Ensure use of medical necessity criteria (InterQual and/or Milliman).
• Manage professional staff with at least two years of management experience.

Qualifications:

• Graduate from a recognized, accredited school of nursing.
• 5 years of acute hospital utilization management experience.
• Current Georgia RN licensure and IQCI certification required.
• Full-time remote position based in Atlanta, GA.
• Part of a corporate team supporting multiple facilities.
• Focus on quality and compliance in healthcare utilization.

Piedmont Healthcare is a healthcare system providing comprehensive medical services. It is a large organization focused on utilization management and quality care.