Utilization Management Supervisor – Women's Health

North Mississippi Medical Center, Inc; United States; On-site; USD 83,000 - 104,000; Full time

Job summary

North Mississippi Health Services seeks a Supervisor of Utilization Management to oversee Women's Hospital Case Management and ensure quality service and outcomes. This role guides staff, assigns patients, coordinates education, recruitment, and treatment to maintain high standards.

The position supervises daily activities, reviews claims, applies interqual criteria, and collaborates with payers and physicians while supporting budgeting and regulatory compliance.

Qualifications

• Excellent organizational and communication skills are required.
• Knowledge of payer sources, laws and cost containment is required.
• Demonstrates ability to care for a broad patient population.

Responsibilities

• Supervises daily activities of Women's Hospital Case Management.
• Reviews claims and applies Interqual criteria for level of care.
• Coordinates staff education and orientation within the department.
• Partners with managers to recruit and plan staffing.
• Ensures compliance with NMHS/NMMC policies and regulatory standards.
• Reports on budget and operational performance daily.

Skills

Organizational skills

Communication skills

Payer knowledge

Interpersonal skills

Regulatory knowledge

Education

Bachelor's Degree in Nursing

Master's Degree in Nursing (not required)

Job description

North Mississippi Health Services seeks a Supervisor of Utilization Management to oversee Women's Hospital Case Management and ensure quality service and outcomes. This role guides staff, assigns patients, coordinates education, recruitment, and treatment to maintain high standards.

The position supervises daily activities, reviews claims, applies interqual criteria, and collaborates with payers and physicians while supporting budgeting and regulatory compliance.