Remote Utilization Review Manager

Hennepin Healthcare; Minneapolis (MN); Hybrid; USD 90,000 - 120,000; Full time

Benefits offered by this job

Medical Insurance

Tuition reimbursement

License and Certification reimburseme

Job summary

Hennepin Healthcare is seeking a Utilization Review Manager to lead the Transitional Care UR team. The role combines remote work with on-site presence as needed and focuses on ensuring appropriate utilization and regulatory compliance.

You will supervise UR coordinators, coordinate with nursing, admissions, and finance, and drive performance improvements across the department. A RN license and leadership experience are required.

Qualifications

• Minimum Bachelor’s degree in nursing or related field with leadership exposure.
• At least 3–5 years of leadership experience in healthcare settings.
• RN licensure and strong knowledge of utilization review processes.

Responsibilities

• Directs and manages the UR team, overseeing daily operations and staff development.
• Collaborates with directors and physicians to optimize medical necessity determinations.
• Ensures regulatory compliance and timely pre-authorizations and post-discharge activities.
• Analyzes metrics to identify avoidable days and opportunities for improvement.
• Supports budgeting, recruitment, retention, and performance improvement initiatives.

Skills

Leadership

Healthcare management

Communication

RN licensure

Regulatory knowledge

Data analytics

Education

Bachelor's degree in nursing or related field

Job description

Hennepin Healthcare is seeking a Utilization Review Manager to lead the Transitional Care UR team. The role combines remote work with on-site presence as needed and focuses on ensuring appropriate utilization and regulatory compliance.

You will supervise UR coordinators, coordinate with nursing, admissions, and finance, and drive performance improvements across the department. A RN license and leadership experience are required.