RN Utilization & Case Management Leader - AI-Enhanced Care

Obsidian; New York (NY); On-site; USD 120,000 - 150,000; Full time

Benefits offered by this job

Opportunity to work on high-impact projects

Collaborate with a world-class AI research organization

Job summary

Obsidian is seeking experienced Utilisation Management and Case Management leaders to shape AI tools that enhance clinical review and improve care coordination. The role involves leading operations, managing physician advisor programs, and ensuring compliance with healthcare regulations.

Ideal candidates will have over 5 years of relevant experience and an active RN license. Join us to contribute to the development of next-generation AI systems in healthcare and collaborate with top-tier research teams.

Qualifications

• 5+ years of experience in utilisation management or clinical review.
• Strong medical necessity review expertise.
• Knowledge of InterQual, MCG, or Milliman guidelines.

Responsibilities

• Lead utilisation management operations for hospitals or health systems.
• Evaluate AI-generated outputs for clinical accuracy.
• Coordinate with teams for appropriate care transitions.

Skills

Utilisation management

Case management

Clinical review

Leadership

Communication skills

Attention to detail

Education

Active RN licensure

CPUR / ACM / CCM credential (preferred)

Tools

UM software platforms (Allscripts)

Job description

Obsidian is seeking experienced Utilisation Management and Case Management leaders to shape AI tools that enhance clinical review and improve care coordination. The role involves leading operations, managing physician advisor programs, and ensuring compliance with healthcare regulations.

Ideal candidates will have over 5 years of relevant experience and an active RN license. Join us to contribute to the development of next-generation AI systems in healthcare and collaborate with top-tier research teams.