Manager Utilization Management & Clinical Appeals
Core
Provides leadership for utilization management nurses, payor liaisons, and preauthorization staff to optimize achievement of goals and objectives while fostering patient-centered care.
Role type
Senior IC manager (utilization management)
Builds
Utilization management department operations and staff competency programs
Domain
Healthcare administration / Utilization management
Required skills
Leadership, budget development, staff orientation, competency assessment, policy development, resource allocation, quality improvement, case management knowledge
Preferred skills
Master's degree in nursing, case management certification, previous case management leadership experience
Technologies
None stated
Responsibilities
Lead utilization management nurses and payor liaisons, develop departmental policies and strategic plans, manage budgets and resources, evaluate staff performance, act as on-call resource
Seniority
Manager, hands-on leadership