The Manager - Utilization Management is responsible for the management of utilization management, utilization review, or concurrent review (on-site or telephonic inpatient care management). He/She will perform reviews of current inpatient services; determine medical appropriateness of inpatient and
outpatient services following evaluation of medical guidelines and benefit determination.  

Job Description:

The Manager - Utilization Management will perform all or some of the following Job description:

• Manage and accountable for professional employees and/or supervisors

• Set team direction, resolve problems and provide guidance to members of own team

• May oversee work activities of other supervisors

• Adapt departmental plans and priorities to address business and operational challenges

• Influence or provide input to forecasting and planning activities

• Product, service or process decisions are most likely to impact multiple groups of employees and/or customers (internal or external).

Minimum Requirements / Knowledge / Skill For Manager - Utilization Management Job

• Previous management experience in a health care related field preferred

• Case management experience desired

• Ability to travel

• Excellent verbal and written communication skills required

• Excellent organizational skills

• Proficient in MS office (including Word and Excel)

• Active, unrestricted RN license.