Remote Utilization Management Nurse Supervisor

Integra Partners; Troy (OH); Remote; USD 75,000 - 99,000; Full time

Benefits offered by this job

Bonus program

401(k) with match

Life insurance

Short-term disability

Medical coverage

Vision coverage

Dental coverage

Paid time off

Parental leave

Sick time

Holidays

Wellness programs

Career development

Job summary

Integra Partners in Michigan seeks an Utilization Management Nurse Supervisor to lead the UM nursing team, balancing hands-on operations with strategic leadership and ensuring compliance with CMS, NCQA, and state requirements.

You will conduct regular 1:1s and performance reviews, lead daily huddles, manage case assignments and authorizations, and provide coaching to improve productivity, timeliness, and quality across the UM function.

Qualifications

• Active, unrestricted RN/LVN/LPN license.
• Minimum 3 years nursing experience in acute, outpatient, or managed care.
• Minimum 2 years utilization management experience.
• Understanding of utilization review, authorizations, and appeals processes.
• Excellent verbal/written communication and organizational skills.
• Experience with Medicare and Medicaid requirements.
• Familiarity with DMEPOS authorization and appeals processes.
• Knowledge of medical necessity criteria (InterQual, CMS, health plan policies).
• Prior leadership, supervisory, or team lead experience in UM.

Responsibilities

• Oversee UM nurses, ensuring productivity, accuracy, and policy adherence.
• Conduct 1:1s, coaching, and performance evaluations for staff growth.
• Lead daily/weekly huddles and set priorities for performance and timeliness.
• Escalate staff questions, operational challenges, or case concerns as needed.
• Promote collaboration, accountability, and continuous improvement.
• Monitor productivity, timeliness, and quality via reporting and audits.
• Oversee case assignment, queue management, and authorization workflows.
• Perform authorization reviews using InterQual, CMS, and plan policies.
• Review clinical and administrative appeals with Medical Director when required.
• Generate daily/weekly productivity and timeliness reports.
• Coordinate with UM leadership and internal partners to resolve escalations.

Skills

Nurse supervision

Staff coaching

Performance reviews

Regulatory compliance

Leadership

Communication skills

Audits & reporting

Utilization management knowledge

InterQual/CMS knowledge

DMEPOS familiarity

Education

RN/LVN/LPN license

Job description

Integra Partners in Michigan seeks an Utilization Management Nurse Supervisor to lead the UM nursing team, balancing hands-on operations with strategic leadership and ensuring compliance with CMS, NCQA, and state requirements.

You will conduct regular 1:1s and performance reviews, lead daily huddles, manage case assignments and authorizations, and provide coaching to improve productivity, timeliness, and quality across the UM function.