PHSO Manager, Utilization Management- Hybrid

University of Vermont Health Network

2d • $47 - $70 • Hybrid

About The Position

The Utilization Management (UM) team at UVM Health is searching for a UM Manager to join their leadership team! Please note: This position is hybrid, allowing for remote and requiring an onsite presence at UVM Health Care Partners quarterly. JOB SUMMARY The Manager of Utilization Management leads teams responsible for oversight of staff and daily operations within the Utilization Management (UM) department. This role provides training, guidance, and support to direct reports, ensures regulatory compliance, and contributes to UM programming across the UVM Health. The manager ensures quality outcomes in medical necessity review, appeals, denials, and patient status determination.

Requirements

• Bachelor’s Degree in Nursing required.
• Current and Active Registered Nurse (RN) license.
• 3-5 years of leadership experience in a healthcare setting required
• 3-5 years of clinical experience in a healthcare setting (or equivalent) required
• Care Management/Care Coordination experience required

Nice To Haves

• Master’s degree in nursing or experience equivalent preferred.
• CM certification preferred
• Case management accreditation required by a nationally recognized accrediting body for case management (examples: CCM, ACM or ANCC certifications), preferred.
• Experience working within a unionized environment preferred.

Responsibilities

• Leads teams responsible for oversight of staff and daily operations within the Utilization Management (UM) department.
• Provides training, guidance, and support to direct reports
• Ensures regulatory compliance
• Contributes to UM programming across the UVM Health
• Ensures quality outcomes in medical necessity review, appeals, denials, and patient status determination.

Benefits

• At UVM Health, we support our employees as passionately as we care for our patients. We offer a comprehensive, total compensation package that includes salary, health and wellness benefits, paid time off, and more.

What This Job Offers

• Job Type: Full-time
• Career Level: Manager
• Number of Employees: 5,001-10,000 employees