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Utilization Management Operations Lead

VirtualVocations
Philadelphia, Pennsylvania, United States
Full-time

A company is looking for a UM Operations Strategy & Implementation Lead responsible for overseeing operational and compliance activities within the Utilization Management department.

Key ResponsibilitiesDrive process improvements and ensure compliance with regulatory requirementsCollaborate with various teams to implement changes and support compliance initiativesAnalyze data to identify gaps and support continuous improvement effortsRequired Qualifications, Training, and EducationBachelor's degree in healthcare, population health, or a related field, or equivalent experienceA minimum of five years of experience in Utilization Management or a related fieldCurrent, unrestricted Registered Nurse (RN) licensure is preferredSix Sigma or project management certifications are preferredExperience with quality control and process standards is preferred

10 hours ago
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