Remote Utilization Management Manager

A renowned coordinated care facility is actively seeking a Remote Utilization Management Manager to join their team. 
The following qualifications are preferred:
Medicaid regulatory experience (Oregon Medicaid preferred)Health Plan Utilization Management: experience reviewing for medical necessity using clinical guidelines as a payer / insurance planStaff supervision and program management experienceRN license in the state of OregonThe Remote Utilization Management Manager will play a vital role within this Coordinated Care Organization (CCO). The Utilization Management Manager is responsible for overseeing the utilization management process and will lead a team of professionals in reviewing healthcare services, ensuring their medical necessity and appropriateness while complying with regulations and industry standards. This role involves developing and updating policies and procedures, monitoring compliance, and analyzing data to improve processes. The Utilization Management Manager will also communicate with healthcare providers and insurance companies, advocate for patients' rights, and drive continuous improvement initiatives. 
Take this exciting opportunity to join a renowned facility as its Remote Utilization Management Manager. This role offers a competitive salary and generous benefits. Apply today to learn more about this opportunity!