UM RN Manager — Health Plan Leadership & Impact

Clinical Management Consultants; Oregon; On-site; USD 120,000 - 150,000; Full time

Job summary

Clinical Management Consultants is seeking an experienced Health Plan Utilization Management RN Manager for the Portland Oregon Metro Area. This leadership role blends clinical judgment with operations, guiding utilization review processes and supporting nursing staff to ensure high-quality, cost-conscious care across multiple counties.

The ideal candidate has strong collaboration with medical directors, case management, and social work, excels at regulatory compliance, and can translate data

Qualifications

• Active RN license in Oregon.
• Experience in utilization management or UR/UM.
• Strong leadership and people management skills.
• Ability to collaborate with medical directors and care teams.

Responsibilities

• Lead UR/UM operations and staff.
• Coordinate review workflows and documentation.
• Monitor timeliness and quality of reviews.
• Partner with medical directors, clinicians, case management and social work.

Skills

Nursing leadership

Clinical judgment

Utilization review

Regulatory compliance

Collaborative/team leadership

Education

BSN

Nurse Manager Certification

Tools

EHR systems

Case management software

Regulatory reporting tools

Job description

Clinical Management Consultants is seeking an experienced Health Plan Utilization Management RN Manager for the Portland Oregon Metro Area. This leadership role blends clinical judgment with operations, guiding utilization review processes and supporting nursing staff to ensure high-quality, cost-conscious care across multiple counties.

The ideal candidate has strong collaboration with medical directors, case management, and social work, excels at regulatory compliance, and can translate data