Utilization Management Lead — Revenue Cycle Excellence

Impact Advisors; Springfield (IL); On-site; USD 120,000 - 190,000; Full time

Benefits offered by this job

Annual performance bonus

Job summary

Impact Advisors is seeking a Utilization Review / Utilization Management Lead to drive day-to-day UM program leadership for a healthcare client. You will oversee concurrent review, continued-stay review, admission and level-of-care status, retrospective review, and related appeals to ensure timely, criteria-based reviews aligned with payer and regulatory requirements.

Collaborating with client clinical, case management, revenue cycle, and physician leadership, you will improve review

Qualifications

• Bachelor’s degree in Healthcare Administration, Nursing, Business Administration, Public Health, or related field.
• 7+ years in healthcare operations, utilization management, case management, revenue cycle, or performance improvement.
• 3+ years of leadership experience managing operational teams, transformation initiatives, or consulting engagements.
• Strong understanding of utilization management operations, patient throughput, care coordination, and healthcare reimbursement.
• Experience leading operational improvement initiatives within provider, payer, or consulting environments.
• Strong analytical, project management, and stakeholder engagement skills; able to manage competing priorities.

Responsibilities

• Lead day-to-day UM operations, including work distribution and coverage.
• Promote consistent application of medical-necessity criteria and appropriate level-of-care status.
• Manage physician-advisor referral and secondary-review processes.
• Oversee optimization of prior authorization, concurrent, retrospective reviews, and appeals workflows.
• Analyze utilization patterns and identify opportunities for improvement.
• Improve turnaround times, productivity, and SLA performance.
• Support implementation of UM technologies, automation tools, and workflow enhancements.
• Establish KPIs for ongoing monitoring and accountability.

Skills

Leadership

Analytics

Project management

Stakeholder engagement

Education

Bachelor’s degree in Healthcare Administration/ Nursing/ Business Admin/ Public Health

Tools

InterQual

MCG

Epic

Cerner

Job description

Impact Advisors is seeking a Utilization Review / Utilization Management Lead to drive day-to-day UM program leadership for a healthcare client. You will oversee concurrent review, continued-stay review, admission and level-of-care status, retrospective review, and related appeals to ensure timely, criteria-based reviews aligned with payer and regulatory requirements.

Collaborating with client clinical, case management, revenue cycle, and physician leadership, you will improve review