Utilization Management Lead – Admissions & Authorizations

Kindred; Las Vegas (NV); On-site; USD 90,000 - 130,000; Full time

Job summary

ScionHealth is seeking a focused Utilization Management Manager to ensure timely access to care by managing front-end prior authorizations and in-house concurrent review authorizations. You will collaborate with hospitals, case management, and payors to secure authorizations, submissions, and appeals.

The role requires strong clinical knowledge, regulatory understanding, and relationship-building to reduce delays and safeguard revenue integrity while supporting quality patient care.

Qualifications

• Postsecondary certificate, diploma, or program graduation from an accredited school of nursing.
• Associate’s Degree in healthcare or a related field is required.
• Bachelor’s Degree in healthcare or a related field preferred.
• Equivalent combination of education and experience (three or more years) may be considered.

Responsibilities

• Manage front-end prior authorizations and in-house concurrent review authorizations.
• Prepare recommendations and appeals to overturn denials.
• Ensure timely processing of authorization requests per regulatory timeframes.
• Coordinate with case management for medical necessity and level of care.
• Document authorization data in tracking systems; liaise with Business Development, admissions, and managed care.

Skills

Relationship building

Regulatory knowledge

Medicare/Medicaid rules

Communication skills

Time management

MS Office

Education

Postsecondary certificate or diploma

Associate’s Degree in healthcare or related field

Bachelor’s Degree in healthcare or related field (preferred)

3+ years of related experience

Job description

ScionHealth is seeking a focused Utilization Management Manager to ensure timely access to care by managing front-end prior authorizations and in-house concurrent review authorizations. You will collaborate with hospitals, case management, and payors to secure authorizations, submissions, and appeals.

The role requires strong clinical knowledge, regulatory understanding, and relationship-building to reduce delays and safeguard revenue integrity while supporting quality patient care.