Strategic UM Denials & Payer Relations Leader

UF Health; Gainesville (FL); On-site; USD 110,000 - 170,000; Full time

Job summary

UF Health in Gainesville, FL is seeking an experienced UM Manager for Denials and Payer Relations to provide operational leadership across enterprise-wide utilization management, authorization management, and medical necessity compliance.

The role partners with Revenue Cycle, Clinical Operations, Physician Advisors, Managed Care, and external payers to reduce denials, improve reimbursement, and drive performance through data analytics and regulatory expertise.

Qualifications

• RN with Bachelor’s degree required; Master’s in Nursing, Healthcare Administration, or related field preferred.
• Minimum five (5) years of Utilization Management, Case Management, Revenue Cycle, or Denials Management experience.
• Minimum three (3) years of leadership experience managing hospital UM operations; Epic experience required.

Responsibilities

• Lead enterprise-wide utilization management activities, including authorization management and medical necessity compliance.
• Reduce preventable denials, monitor payer performance, and optimize reimbursement.
• Collaborate with Revenue Cycle, Clinical Operations, Physician Advisors, Managed Care, and external payers to align processes.

Skills

Leadership

Regulatory interpretation

Data analytics

Prioritization

Education

Bachelor’s degree in nursing

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

Tools

Epic

Job description

UF Health in Gainesville, FL is seeking an experienced UM Manager for Denials and Payer Relations to provide operational leadership across enterprise-wide utilization management, authorization management, and medical necessity compliance.

The role partners with Revenue Cycle, Clinical Operations, Physician Advisors, Managed Care, and external payers to reduce denials, improve reimbursement, and drive performance through data analytics and regulatory expertise.