RN Utilization Review Manager

RN Utilization Review Manager, responsible for overseeing the daily operations of Utilization Management staff in a full-time, salaried position, including team management, performance monitoring, and compliance with regulatory standards. Key Responsibilities Supervise and manage the Utilization Management team, including scheduling and performance evaluations Ensure compliance with documentation standards and participate in audits for regulatory readiness Analyze operational data to drive performance improvements and resolve issues collaboratively Required Qualifications, Training, and Education Current, unrestricted RN license in the United States or U.S. territory Graduate of an accredited nursing program (ADN or diploma required; BSN preferred) 1-2 years of experience in care management or utilization management 1+ year of informal leadership experience or direct management experience preferred Knowledge of medical claims and coding (ICD-10, CPT, HCPCS) is essential