Strategic Leader, UM Denials & Payer Relations

Socket.dev; Gainesville (FL); On-site; USD 120,000 - 180,000; Full time

Job summary

Socket.dev seeks a senior UM leader to oversee enterprise utilization management, denials prevention, and payer relations. The role requires RN licensure and strong data analytics to drive performance and compliance.

The ideal candidate will have five+ years in UM/denials management, leadership experience, and familiarity with Epic, to optimize reimbursement and regulatory alignment across the organization.

Qualifications

• Bachelor’s degree in nursing required.
• Master’s degree in nursing, Healthcare Administration, Business Administration, or related field preferred.

Responsibilities

• Provide operational leadership for enterprise-wide utilization management activities including authorization management and denial prevention.
• Serve as liaison among Utilization Management, Revenue Cycle, Clinical Operations, and external payers to ensure accurate clinical review processes.

Skills

Data analysis

Leadership

Education

Bachelor’s degree in nursing

Master’s degree in nursing, Healthcare Administration, Business Administration, or related field

Tools

Epic

Job description

Socket.dev seeks a senior UM leader to oversee enterprise utilization management, denials prevention, and payer relations. The role requires RN licensure and strong data analytics to drive performance and compliance.

The ideal candidate will have five+ years in UM/denials management, leadership experience, and familiarity with Epic, to optimize reimbursement and regulatory alignment across the organization.