Manager, Utilization Review
Benefits
Unlimited PTO
Essential Duties and Responsibilities:
- Supervise day-to-day operations of assigned Utilization Management staff.
- Provide full people management for assigned Utilization Management teams.
- Monitor documentation for completeness and compliance.
Level II:
- Drive team performance against key metrics.
- Analyze data to identify trends and opportunities for improvement.
- Collaborate with cross-functional partners to resolve issues.
Qualifications:
- Current, unrestricted RN license.
- Knowledgeable of Federal, State, DMHC, CMS and ERISA regulations.
- Experience interpreting and operationalizing policies.
Personify Health
Personify Health has created a personalized health platform, bringing health plan administration, wellbeing solutions, and care navigation together. Their data-driven solutions aim to reduce costs while improving health outcomes, empowering people to lead healthier lives.