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Daily Responsibilities RN Supervisor of UM: 

Position Purpose: Supervise the daily operations of the utilization management (UM) department

Supervise the daily operations of the UM staff

Ensure appropriate usage of resources in order to facilitate the UM process

Ensure compliance within applicable state program guidelines

Evaluate compliance policies and procedures and analyze/recommend enhancements

Assist with ensuring consistent data collection from UM staff that is used to assist the company in achieving corporate goals, to improve monitoring and reporting in order to meet external requirements

Identify opportunities for process improvements necessary to facilitate department functions

Educate staff as necessary to ensure consistent performance and adhere to standards

Assist UM Manager and Director with coordinating and facilitating system processes with providers, partners, vendors, and subcontractors as necessary

Requirements:

Must be Registered Nurse

3 – 5 years UM experience, Either PA or CR

Thorough knowledge of utilization management and clinical nursing.

Familiarity with Medicaid managed care practices and policies, CHIP, and SCHIP preferred

Case Management Certification (CCM) preferred.

Managed Care Experience STONGLY preferred

Supervisory Experience a must!

Hours for this Position:

Mon-Fri 8a-5p

Advantages of this Opportunity:

Competitive salary

Fun and positive work environment

Benefits start 1st of the month after hire

Want More Information?

• If you are interested in applying to this position, please contact Ashley Greene @ 407-478-0332 ext 169 or email and click the Green "I’m Interested" Button to email your resume.