Texas Licensed Utilization Management Supervisor

Job Summary

A company is looking for a Supervisor, Utilization Management.

Key Responsibilities

• Supervises the Prior Authorization, Concurrent Review, and/or Retrospective Review Clinical Review team to ensure appropriate care to members
• Monitors UM resources for adherence to performance, compliance, quality, and efficiency standards
• Collaborates with the team to resolve complex care member issues and identifies opportunities for process improvements

Required Qualifications

• Graduate of an Accredited School of Nursing or Bachelor's degree
• 4+ years of related experience in utilization management
• Registered Nurse (RN) State Licensure and/or Compact State Licensure required
• Knowledge of utilization management principles preferred