RN Utilization Management Manager – Hybrid Lead

Cambia Health Solutions; Salt Lake City (UT); Hybride; USD 105 000 - 172 000; Plein temps

Résumé du poste

Cambia Health Solutions in Salt Lake City is seeking a Manager of Utilization Management to lead UM programs across prospective, concurrent, retrospective reviews and post-service audits. This hybrid role focuses on people leadership, policy execution, and collaborating with multiple departments to improve care and efficiency.

The candidate will oversee staff performance, budgets, and program quality while guiding teams across offices.

Qualifications

• Bachelor’s degree in nursing or related field; masters preferred.
• RN licensure in the United States.
• Minimum 5 years of clinical care and 5 years of leadership experience.
• 7 years of insurance industry experience or equivalent.

Responsabilités

• Lead development and execution of utilization and payment review policies.
• Oversee staff performance reviews, development, hiring and retention.
• Communicate objectives and monitor metrics to ensure deliverables.
• Manage department budget and resources.
• Develop and present educational updates to other departments.
• Provide leadership to drive positive outcomes across teams.

Connaissances

Leadership

Communication

Team development

Project management

Healthcare knowledge

Clinical mgmt

AI tools

Issue identification

Formation

Nursing degree

RN licensure

Master’s preferred

Outils

N/A

Description du poste

Cambia Health Solutions in Salt Lake City is seeking a Manager of Utilization Management to lead UM programs across prospective, concurrent, retrospective reviews and post-service audits. This hybrid role focuses on people leadership, policy execution, and collaborating with multiple departments to improve care and efficiency.

The candidate will oversee staff performance, budgets, and program quality while guiding teams across offices.