Talent.com
Utilization Management Nurse Supervisor
Utilization Management Nurse SupervisorIntegra Partners • Troy, MI, US
Utilization Management Nurse Supervisor

Utilization Management Nurse Supervisor

Integra Partners • Troy, MI, US
job_description.job_card.30_days_ago
serp_jobs.job_preview.job_type
  • serp_jobs.job_card.full_time
  • serp_jobs.filters_job_card.quick_apply
job_description.job_card.job_description

The Utilization Management (UM) Nurse Supervisor is responsible for providing direct leadership and oversight to the UM nursing team.

This role ensures team performance, accountability, and professional development by conducting regular 1 :

  • 1s, managing performance reviews, and driving compliance with organizational, state, and federal requirements.
  • The Supervisor balances hands-on operational responsibilities with leadership duties, serving as both a mentor and performance manager for frontline staff.

Salary :

  • $75,000.00 / Annually  JOB QUALIFICATIONS : KNOWLEDGE / SKILLS / ABILITIES   The UM Nurse Team Lead’s responsibilities include but are not limited to : Provide day-to-day supervision of UM nurses, ensuring productivity, accuracy, and adherence to policies and processes.
  • Conduct regular 1 :

  • 1s, coaching sessions, and performance evaluations to support staff growth and accountability.
  • Lead daily / weekly huddles, communicate priorities, and set expectations for performance and timeliness.
  • Serve as first point of escalation for staff questions, operational challenges, or case-related concerns.
  • Promote a culture of collaboration, accountability, and continuous improvement.
  • Monitor team productivity, timeliness, and quality of work through reporting and audits.
  • Take accountability for overall team performance, escalating issues as needed to the UM Clinical Manager.
  • Ensure compliance with all regulatory, contractual, and accreditation standards (CMS, NCQA, state-specific requirements).
  • Support audit preparation, quality initiatives, and corrective action plans as needed.
  • Oversee case assignment, queue management, and authorization workflows to ensure timely completion.
  • Perform authorization reviews as needed, utilizing federal / state mandates, plan benefit language, and medical necessity criteria (e.g., InterQual, CMS, health plan policies).
  • Review and process clinical and administrative appeals; coordinate with Medical Director when required.
  • Generate and review daily / weekly reporting on productivity and case timeliness.
  • Manage team calendars, including PTO, planned outages, and rotation schedules.
  • Participate in user acceptance testing (UAT), system / process improvements, and special projects.
  • Act as liaison between UM staff and UM leadership to ensure clear communication of priorities, policies, and workflow changes.
  • Collaborate with internal partners (e.g., Provider Relations, Quality) to resolve escalations and address utilization management issues.
  • Represent UM nursing team in internal meetings and external stakeholder interactions as directed.
  • Remote work environment with expectations for timely communication and responsiveness.
  • Must be able to handle confidential and sensitive information in compliance with company policies and regulations.
  • Flexibility to adapt to changing priorities, systems, and workflows in a fast-paced environment.
  • EDUCATION :

  • Active, unrestricted Registered Nurse, Licensed Vocational Nurse, or Licensed Practical Nurse license EXPERIENCE : Minimum 3 years of nursing experience in acute, outpatient, or managed care setting.
  • Minimum 2 years of utilization management experience in a payer or managed care environment.
  • Strong understanding of utilization review, authorizations, and appeals processes.
  • Excellent verbal / written communication and organizational skills.
  • Experience with Medicare and Medicaid requirements.
  • Familiarity with DMEPOS authorization and appeals processes.
  • Knowledge of medical necessity criteria (InterQual, CMS, health plan policies).
  • Prior leadership, supervisory, or team lead experience in a UM setting.
  • Benefits Offered Competitive compensation and annual bonus program 401(k) retirement program with company match Company-paid life insurance Company-paid short term disability coverage (location restrictions may apply) Medical, Vision, and Dental benefits Paid Time Off (PTO) Paid Parental Leave Sick Time Paid company holidays and floating holidays Quarterly company-sponsored events Health and wellness programs Career development opportunities Remote Opportunities We are actively seeking new colleagues in :

  • Arizona, Colorado, Connecticut, Florida, Georgia, Idaho, Illinois, Kentucky, Massachusetts, Michigan, North Carolina, New Jersey, New York, Ohio, Pennsylvania, South Carolina, Tennessee, Texas, Virginia, Vermont, and Washington.
  • Our Story Founded in 2005, Integra Partners is a leading national durable medical equipment, prosthetic, and orthotic supplies (DMEPOS) network administrator.
  • Our mission is to improve the quality of life for the communities we serve by reimagining access to in-home healthcare.
  • We connect Payers, Providers, and Members through innovative technology and streamlined workflows affording Members access to top local Providers and culturally competent care.
  • By focusing on transparency, accountability, and adaptability, we help deliver better health outcomes and more efficient management of complex healthcare benefits.
  • Integra Partners is a wholly owned subsidiary of Point32Health.
  • With a location in Michigan plus a remote workforce across the United States, Integra has a culture focused on collaboration, teamwork, and our values :

  • One Team, Drive Results, Push the Boundaries, Value Others, and Build Community.
  • We’re looking for energetic, talented, and dedicated individuals to join our team.
  • See what opportunities we have available; there may be a role for you to engage in a challenging yet rewarding career in healthcare.
  • We look forward to learning more about you.
  • Integra Partners is an equal opportunity employer.
  • We are committed to providing reasonable accommodations and will work with you to meet your needs.
  • If you are a person with a disability and require assistance during the application process, please don’t hesitate to reach out.
  • We celebrate our inclusive work environment and welcome members of all backgrounds and perspectives.
  • Powered by JazzHR
  • serp_jobs.job_alerts.create_a_job

    Utilization Management Nurse • Troy, MI, US

    Job_description.internal_linking.related_jobs
    Utilization Review Clinical Liaison

    Utilization Review Clinical Liaison

    VirtualVocations • Warren, Michigan, United States
    serp_jobs.job_card.full_time
    A company is looking for a Utilization Review Clinical Liaison.Key Responsibilities Serve as the primary point of contact for 1st level utilization review (UR) cases Coordinate 2nd level escalat...serp_jobs.internal_linking.show_more
    serp_jobs.last_updated.last_updated_variable_days • serp_jobs.job_card.promoted
    Utilization Management Nurse Supervisor

    Utilization Management Nurse Supervisor

    VirtualVocations • Detroit, Michigan, United States
    serp_jobs.job_card.full_time
    A company is looking for a Utilization Management Nurse Supervisor to provide leadership and oversight to the nursing team. Key Responsibilities Supervise UM nurses, ensuring productivity, accurac...serp_jobs.internal_linking.show_more
    serp_jobs.last_updated.last_updated_variable_days • serp_jobs.job_card.promoted
    Travel Nurse RN - Case Management - $1,885 per week

    Travel Nurse RN - Case Management - $1,885 per week

    Cross Country Nurses • Detroit, MI, USA
    serp_jobs.job_card.full_time
    Cross Country Nurses is seeking a travel nurse RN Case Management for a travel nursing job in Detroit, Michigan.Job Description & Requirements. As a case management nurse (RN CM), you will collabora...serp_jobs.internal_linking.show_more
    serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted
    Travel Nurse - RN - SDU - Stepdown Unit - $1805.47 / Week - Hiring Now

    Travel Nurse - RN - SDU - Stepdown Unit - $1805.47 / Week - Hiring Now

    FlexCare • Rochester, MI, US
    serp_jobs.job_card.full_time
    FlexCare is seeking an experienced Stepdown Unit Registered Nurse for an exciting Travel Nursing job in Rochester, MI.Shift : 3x12 hr days Start Date : 10 / 27 / 2025 Duration : 13 weeks Pay : $1805.Why Cl...serp_jobs.internal_linking.show_more
    serp_jobs.last_updated.last_updated_variable_days • serp_jobs.job_card.promoted
    Travel Nurse - RN - Psych - Psychiatric - $1780 / Week - Hiring Now

    Travel Nurse - RN - Psych - Psychiatric - $1780 / Week - Hiring Now

    Cynet Health • New Baltimore, MI, US
    serp_jobs.job_card.full_time
    Cynet Health is seeking an experienced Psychiatric Registered Nurse for an exciting Travel Nursing job in New Baltimore, MI. Shift : 3x12 hr nights Start Date : 10 / 27 / 2025 Duration : 13 weeks Pay : $178...serp_jobs.internal_linking.show_more
    serp_jobs.last_updated.last_updated_variable_days • serp_jobs.job_card.promoted
    Travel Nurse RN - Administration / Management - $2,014 to $2,214 per week in Detroit, MI

    Travel Nurse RN - Administration / Management - $2,014 to $2,214 per week in Detroit, MI

    TravelNurseSource • Warren, Michigan, US
    serp_jobs.job_card.full_time
    TravelNurseSource is working with Titan Medical Group to find a qualified Admin / Mgmt RN in Detroit, Michigan, 48201!.Travel Nurse RN - Case Management. Titan Medical is looking for travelers to fill...serp_jobs.internal_linking.show_more
    serp_jobs.last_updated.last_updated_variable_days • serp_jobs.job_card.promoted
    Oregon Licensed Utilization Review Nurse

    Oregon Licensed Utilization Review Nurse

    VirtualVocations • Warren, Michigan, United States
    serp_jobs.job_card.full_time
    A company is looking for a Utilization Review Nurse.Key Responsibilities Monitor utilization practices from preadmission to discharge to ensure cost-effective resource use and quality patient car...serp_jobs.internal_linking.show_more
    serp_jobs.last_updated.last_updated_variable_days • serp_jobs.job_card.promoted
    Utilization Review Manager

    Utilization Review Manager

    Acadia Healthcare • New Baltimore, MI, US
    serp_jobs.job_card.full_time
    Harbor Oaks Hospital, New Baltimore's leading Mental Health and Addiction Treatment Center is seeking a passionate Utilization Review Manager to work at our facility in New Baltimore, MI.Monitor ut...serp_jobs.internal_linking.show_more
    serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted
    Ohio Licensed Utilization Nurse Consultant

    Ohio Licensed Utilization Nurse Consultant

    VirtualVocations • Detroit, Michigan, United States
    serp_jobs.job_card.full_time
    A company is looking for a Utilization Management Nurse Consultant.Key Responsibilities Assess, plan, implement, coordinate, monitor, and evaluate healthcare services / benefits for members Gather...serp_jobs.internal_linking.show_more
    serp_jobs.last_updated.last_updated_variable_days • serp_jobs.job_card.promoted
    Utilization Management RN - Post Acute Care

    Utilization Management RN - Post Acute Care

    Tap Growth ai • Detroit, Michigan, US
    serp_jobs.job_card.full_time
    We're Hiring : Utilization Management RN - Post Acute Care!.We are seeking an experienced Registered Nurse to join our team as a Utilization Management Nurse focusing on Medicare Advantage Post-Acut...serp_jobs.internal_linking.show_more
    serp_jobs.last_updated.last_updated_30
    Central Scheduling Supervisor

    Central Scheduling Supervisor

    CNS Healthcare • Clarkston, MI, US
    serp_jobs.job_card.full_time
    We are seeking candidates who want to join our impact-driven organization and who share our passion for advancing integrated mental and physical healthcare and eliminating stigma by providing servi...serp_jobs.internal_linking.show_more
    serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted
    Travel Nurse RN - Intensive Care Unit (ICU) / Critical Care - $1,808 to $2,008 per week in Petoskey, MI

    Travel Nurse RN - Intensive Care Unit (ICU) / Critical Care - $1,808 to $2,008 per week in Petoskey, MI

    TravelNurseSource • Detroit, Michigan, US
    serp_jobs.job_card.full_time
    TravelNurseSource is working with Titan Medical Group to find a qualified ICU / Critical Care RN in Petoskey, Michigan, 49770!. Titan Medical is looking for travelers to fill a Travel ICU position for...serp_jobs.internal_linking.show_more
    serp_jobs.last_updated.last_updated_variable_hours • serp_jobs.job_card.promoted • serp_jobs.job_card.new
    State Licensed Utilization Review Nurse

    State Licensed Utilization Review Nurse

    VirtualVocations • Detroit, Michigan, United States
    serp_jobs.job_card.full_time
    A company is looking for a Utilization Review Nurse (PRN).Key Responsibilities Review and evaluate electronic medical records for emergency admissions to assess medical necessity Apply clinical ...serp_jobs.internal_linking.show_more
    serp_jobs.last_updated.last_updated_variable_days • serp_jobs.job_card.promoted
    Travel Nurse RN - Case Manager, Utilization Review - $2,091 per week

    Travel Nurse RN - Case Manager, Utilization Review - $2,091 per week

    GQR Healthcare • Clinton Twp, MI, US
    serp_jobs.job_card.full_time
    GQR Healthcare is seeking a travel nurse RN Case Manager, Utilization Review for a travel nursing job in Clinton Twp, Michigan. Job Description & Requirements.Pay package is based on 8 hour shif...serp_jobs.internal_linking.show_more
    serp_jobs.last_updated.last_updated_variable_days • serp_jobs.job_card.promoted
    Travel Nurse RN - Case Management - $2,302 per week

    Travel Nurse RN - Case Management - $2,302 per week

    First Connect Health • Detroit, MI, United States
    serp_jobs.job_card.permanent
    First Connect Health is seeking a travel nurse RN Case Management for a travel nursing job in Detroit, Michigan.Job Description & Requirements. Acute Inpatient Case Manager (RN or MSW) – Michigan.Se...serp_jobs.internal_linking.show_more
    serp_jobs.last_updated.last_updated_variable_days • serp_jobs.job_card.promoted
    Unit Manager

    Unit Manager

    Regency at Waterford • WATERFORD TOWNSHIP, Michigan, United States
    serp_jobs.job_card.full_time
    Are you an experienced Registered Nurse looking for a leadership role? Do you have a passion for leading and teaching other skilled nursing staff? The Unit Manager provides, plans, coordinates, or ...serp_jobs.internal_linking.show_more
    serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted
    RN Nurse Manager

    RN Nurse Manager

    Universal Health Services, Inc. • Dearborn, MI, United States
    serp_jobs.job_card.full_time
    Metropolitan Behavioral Health (a UHS Facility).A growing 144-bed behavioral health facility - Metropolitan Behavioral Hospital provides a full continuum of inpatient services across the entire pat...serp_jobs.internal_linking.show_more
    serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted
    Unit Manager - Sign On Bonus

    Unit Manager - Sign On Bonus

    Regency at Waterford • WATERFORD TOWNSHIP, Michigan, United States
    serp_jobs.job_card.full_time
    Are you an experienced Registered Nurse looking for a leadership role? Do you have a passion for leading and teaching other skilled nursing staff? The Unit Manager provides, plans, coordinates, or ...serp_jobs.internal_linking.show_more
    serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted