Remote RN Supervisor — Utilization Management & Prior Auth

CommonSpirit Health; Rancho Cordova (CA); On-site; USD 85,000 - 100,000; Full time

Benefits offered by this job

Work-from-home equipment provided

Rotating weekends schedule

Job summary

CommonSpirit Health is seeking a Supervisor of Utilization Management (UM). This remote position requires overseeing the Pre-Authorization team while ensuring compliance with guidelines. Your leadership will be essential in promoting quality patient care.

The ideal candidate will have significant experience in Utilization Management, strong clinical knowledge, and excellent interpersonal skills. You will manage team schedules and ensure appropriate evaluations of referrals.

Qualifications

• Five (5) years clinical experience required.
• Three (3) years Utilization experience in health plan/UM operations required.
• Strong knowledge of Utilization Management processes.

Responsibilities

• Coordinate daily operations of the UM Pre-Authorization team.
• Ensure timely response and evaluation of referral reviews.
• Organize pre-authorization meetings.

Skills

Leadership and management skills

Knowledge of Utilization Management

Communication skills

Interpersonal skills

Data analysis

Education

Bachelor's degree or equivalent experience

CA Registered Nurse (RN) license

Tools

Microsoft Office (Word and Excel)

Job description

CommonSpirit Health is seeking a Supervisor of Utilization Management (UM). This remote position requires overseeing the Pre-Authorization team while ensuring compliance with guidelines. Your leadership will be essential in promoting quality patient care.

The ideal candidate will have significant experience in Utilization Management, strong clinical knowledge, and excellent interpersonal skills. You will manage team schedules and ensure appropriate evaluations of referrals.