RN Utilization Management Leader | Hybrid Role

Cambia Health; Salt Lake City (UT); Hybrid; USD 105,000 - 172,000; Full time

Benefits offered by this job

Work from home options

Competitive base pay

Market-leading 401(k) with company 401

Paid time off and holidays

Job summary

Cambia Health in Salt Lake City, UT leads a hybrid Manager Utilization Management role, requiring RN licensure and 5+ years in clinical care and leadership. The role oversees policy execution across plans, manages staff, budgets, and collaborates with partners to ensure high-quality utilization management outcomes.

The position offers work-from-home options and a comprehensive benefits package, with a salary range and bonus targets that reflect market norms for senior clinical leadership roles

Qualifications

• Bachelor's degree in nursing or related field; master's preferred.
• 5+ years clinical care experience.
• 5+ years leadership experience.
• 7 years insurance industry experience or equivalent.
• Current unrestricted RN licensure.

Responsibilities

• Lead development and execution of utilization and payment review policies and standards.
• Oversee policy updates and process improvements to ensure quality and service.
• Manage staff performance reviews, development, hiring, coaching and retention.
• Develop supervisors and participate in talent management activities.
• Communicate organizational objectives and team goals regularly.
• Monitor results and metrics to ensure deliverables and regulatory compliance.
• Collaborate with leaders across departments to resolve issues.
• Manage department budget, expenditures, and resources; oversee project plans.
• Establish long-term goals and adapt plans as needed; create visibility for programs.
• Develop resource materials and provide education about programs to stakeholders.

Skills

Leadership experience

Clinical care

Insurance industry exp.

RN licensure

Education

Bachelor's degree in nursing or related field

Master's preferred

Job description

Cambia Health in Salt Lake City, UT leads a hybrid Manager Utilization Management role, requiring RN licensure and 5+ years in clinical care and leadership. The role oversees policy execution across plans, manages staff, budgets, and collaborates with partners to ensure high-quality utilization management outcomes.

The position offers work-from-home options and a comprehensive benefits package, with a salary range and bonus targets that reflect market norms for senior clinical leadership roles