Utilization Management Lead - Healthcare Ops & Performance

Impact Advisors; Oregon; Hybrid; USD 130,000 - 190,000; Full time

Benefits offered by this job

Annual performance bonus

Comprehensive benefits package

Job summary

Impact Advisors, LLC is a nationally recognized healthcare management consulting firm delivering Best in KLAS advisory, implementation, and optimization services. The UR/UM Lead oversees day-to-day utilization management for a client, aligning reviews with payer requirements and regulatory standards.

This role partners with clinical, revenue cycle, and leadership teams to drive throughput, reduce denials, and support length-of-stay goals.

Qualifications

• Bachelor's degree in Healthcare Administration, Nursing, Business Administration, Public Health, or related field.
• 7+ years of experience in healthcare operations, utilization management, care management, revenue cycle, or performance improvement.
• 3+ years of leadership experience managing operational teams, transformation initiatives, or consulting engagements.
• Strong analytical, project management, and stakeholder engagement skills; able to manage competing priorities.

Responsibilities

• Lead operational assessments of utilization management, case management, patient throughput, and care coordination functions.
• Direct daily UM operations, including work distribution, review prioritization, escalation, and coverage.
• Promote consistent application of medical-necessity criteria and appropriate level-of-care status.
• Develop operational strategies to optimize reimbursement and financial performance.
• Establish dashboards and reporting tools to monitor throughput performance and operational outcomes.

Skills

Leadership

Healthcare operations

Project management

Stakeholder engagement

Education

Bachelor's degree

Tools

Epic

InterQual

MCG

Cerner

Job description

Impact Advisors, LLC is a nationally recognized healthcare management consulting firm delivering Best in KLAS advisory, implementation, and optimization services. The UR/UM Lead oversees day-to-day utilization management for a client, aligning reviews with payer requirements and regulatory standards.

This role partners with clinical, revenue cycle, and leadership teams to drive throughput, reduce denials, and support length-of-stay goals.