Remote UM Supervisor - Utilization Management

Imagine360, LLC; United States; On-site; USD 85,000 - 120,000; Full time

Benefits offered by this job

Health plan options

Disability & life insurance

Parental Leave

PTO & Holidays

Tuition reimbursement

401k

Professional development

Diversity & inclusion

Job summary

Imagine360 is seeking a Supervisor, Utilization Management to lead the UM Nurses and related programs. The role supports supervision, policy implementation, and ongoing education within a remote work environment.

The ideal candidate holds an active RN license with 3+ years in clinical roles and experience in utilization review, URAC programs, and team mentoring. Strong communication and data reporting skills are essential.

Qualifications

• A nursing degree or diploma from an accredited school is required.
• Bachelor's degree in nursing is preferred but not required.
• Minimum 3 years in a clinical role with direct patient care.
• Experience in Utilization Review, Case Management, or related clinical work.
• Experience mentoring or managing clinical or non-clinical staff.
• Experience in utilization review and URAC accredited programs preferred.
• Knowledge of ICD and CPT codes.

Responsibilities

• Supervise UM Nurses and related programs, reporting to Senior Manager.
• Edit and implement policies to meet regulatory and business needs.
• Coordinate training, orientation, and ongoing education.
• Oversee daily team activities and case assignments.
• Track metrics, QA, and reporting; manage staffing needs.
• Conduct 1:1 coaching sessions and lead nurse meetings.
• Lead hiring processes and project initiatives to improve services.
• Collaborate with Quality Management and perform chart audits.

Skills

Independent work

MS Office

Problem solving

Communication skills

Presentation skills

Professional development

Education

Nursing degree or diploma

Bachelor's degree in nursing (preferred)

Tools

Microsoft Outlook

Microsoft Word

Microsoft Excel

Microsoft PowerPoint

Job description

Imagine360 is seeking a Supervisor, Utilization Management to lead the UM Nurses and related programs. The role supports supervision, policy implementation, and ongoing education within a remote work environment.

The ideal candidate holds an active RN license with 3+ years in clinical roles and experience in utilization review, URAC programs, and team mentoring. Strong communication and data reporting skills are essential.