Remote Utilization Management Supervisor Lead UM Excellence

TriWest Healthcare Alliance; Phoenix (AZ); On-site; USD 91,000 - 107,000; Full time

Benefits offered by this job

Medical, Dental and Vision Coverage

Paid time off

401(k) Retirement Savings Plan

Job summary

TriWest Healthcare Alliance seeks a Nurse to supervise daily Utilization Management operations under the TRICARE contract. You will coordinate across teams to meet contractual metrics and ensure quality, efficient care delivery. The role builds staff capability and supports program data reporting.

The ideal candidate is a Registered Nurse with leadership experience, U.S. citizenship, and a background in utilization review or case management.

Qualifications

• RN license is required and must be active in good standing.
• 3+ years in healthcare settings with leadership experience.
• 3+ years supervising or leading healthcare staff.
• 2+ years utilization review or case management experience.
• U.S. Citizenship is required.

Responsibilities

• Supervise day-to-day Utilization Management operations to ensure efficiency.
• Communicate updates, policy changes and performance results to staff.
• Schedule work shifts and manage caseloads to ensure adequate staffing.
• Monitor adherence to criteria, internal guidelines, and contract requirements.
• Prepare reports tracking UM activities and trends.
• Collaborate with clinical operations and contracted partners to meet UM goals.

Skills

Leadership

Coaching

Communication

Time management

Problem solving

Multitasking

Organizational skills

Mentoring

Staff development

Education

Registered Nurse license

Tools

InterQual criteria

Medical management systems

Microsoft Office

Job description

TriWest Healthcare Alliance seeks a Nurse to supervise daily Utilization Management operations under the TRICARE contract. You will coordinate across teams to meet contractual metrics and ensure quality, efficient care delivery. The role builds staff capability and supports program data reporting.

The ideal candidate is a Registered Nurse with leadership experience, U.S. citizenship, and a background in utilization review or case management.