Supervisor of Utilization Management – Long Term Support Service

VillageCare; New York (NY); Remote; USD 102,000 - 116,000; Full time

Job summary

Join VillageCare as a Full-Time Supervisor of Utilization Management in New York. This role involves leading a dedicated team of nurses, optimizing resource utilization, and improving care quality while enjoying the flexibility of remote work. With comprehensive benefits and a commitment to healthcare excellence, this is a chance to advance your career and make a positive impact.

Benefits

Medical Insurance

Dental Insurance

Vision Insurance

Life Insurance

Paid Time Off

Qualifications

• Graduate of an accredited nursing program; BSN required.
• Current unrestricted NYS RN license.
• Minimum two years of utilization review experience.

Responsibilities

• Supervise a team of registered nurses.
• Monitor clinical reviews for timely processing.
• Conduct performance evaluations and coaching.

Skills

Organizational skills

Problem-solving

Customer-focused approach

Education

BSN

Advanced degree (preferred)

Tools

Microsoft Office Suite

Job description

Supervisor of Utilization Management – Long Term Support Service

Join VillageCare as a Full-Time Supervisor of Utilization Management - Long Term Support Service and play a vital role in transforming healthcare delivery. This position offers the opportunity to impact lives positively while leading a dedicated team. Your problem-solving skills and customer-focused approach will be essential in optimizing resource utilization and improving care quality. Enjoy the flexibility of remote work, enabling a healthy work-life balance.

At VillageCare, you'll collaborate with passionate colleagues in a culture that values excellence and integrity. We offer comprehensive benefits including Medical, Dental, Vision, Life Insurance, and Paid Time Off. This is a chance to advance your career and make a difference in healthcare.

Must reside in NY, NJ, or CT

VillageCare is a community-based, not-for-profit organization serving individuals with chronic care needs, seniors, and those requiring continuing or managed care services. With over 45 years of experience, our mission is to promote healing, health, and well-being through community and residential programs as well as managed care services.

Key Responsibilities

• Supervise a team of registered nurses, providing guidance on prior authorization reviews for long-term support services.
• Monitor clinical reviews to ensure timely processing of requests.
• Support the director in handling complaints and quality of care issues.
• Provide education on VillageCareMAX benefits.
• Perform clinical review duties as needed and contribute to quality initiatives for audits.
• Conduct performance evaluations and coaching to develop a high-performing team.

Qualifications

• Graduate of an accredited nursing program; BSN required, advanced degree preferred.
• Current unrestricted NYS RN license.
• Minimum two years of utilization review experience within a Managed Care Organization.
• At least one year in a supervisory healthcare role.
• Knowledge of precertification, Medicaid, and Medicare regulations.
• Proficiency in Microsoft Office Suite; willingness to learn advanced software.
• Ability to apply InterQual Care Guidelines and understand coverage limitations.
• Strong organizational skills and ability to manage multiple projects.

Connect with our team today! We welcome candidates who are passionate about healthcare excellence. VillageCare is an Equal Opportunity Employer.

Salary: $102,549.17 - $115,367.82 per year