Remote Utilization Review Manager — Healthcare Leader

Ensemble Health Partners; United States; Remote; USD 92.000 - 139.000; Vollzeit

Benefits dieser Stelle

Bonus incentives

Paid certifications

Tuition reimbursement

Comprehensive benefits

Career advancement

Zusammenfassung

Ensemble seeks a Manager for Utilization Review to lead the centralized Virtual UM program and guide clinical and operational excellence in inpatient, observation, and outpatient authorization and appeals. The role collaborates with hospital-based leaders, coding, care coordination, and health information management to drive outcomes.

The position is remote within the United States, offering bonus incentives, certifications, and tuition reimbursement as part of a comprehensive benefits package.

Qualifikationen

• Requires nursing leadership and clinical oversight experience.
• Experience with utilization management processes.
• Ability to analyze data and implement improvement plans.

Aufgaben

• Develops and manages Medical Management department activities to meet targets.
• Oversees UM staff and ensures compliance with regulations.
• Collaborates with Care Coordination, CDS, and HIM for process improvements.

Kenntnisse

Decision Making

Courage

Influencing

Coaching & Developing

Emotional Intelligence

Inclusive Environment

Ausbildung

Associate Degree in Nursing

Bachelor’s Degree in Nursing

Jobbeschreibung

Ensemble seeks a Manager for Utilization Review to lead the centralized Virtual UM program and guide clinical and operational excellence in inpatient, observation, and outpatient authorization and appeals. The role collaborates with hospital-based leaders, coding, care coordination, and health information management to drive outcomes.

The position is remote within the United States, offering bonus incentives, certifications, and tuition reimbursement as part of a comprehensive benefits package.