Utilization Management RN
About The Position
At WelbeHealth, we are transforming the reality of senior care by providing an all-inclusive healthcare option to the most vulnerable senior population, functioning as both a care provider and care plan to those individuals we serve. Our Health Plan Services team plays a critical role in our participant’s journey and our Utilization Management team ensures we can provide timely, quality, compliant, and cost-effective care to our participants. By guiding this team, the Utilization Management RN Supervisor drives the continuous improvement of our care delivery processes.
Requirements
- Minimum of three (3) years of relevant clinical nursing experience
- Two (2) years of supervisory experience with demonstrated aptitude to mentor and develop team members
Nice To Haves
- Strong preference for prior PACE experience
- Inpatient care experience PREFERRED
Responsibilities
- Direct oversight of day-to-day operations within the designated UM team
- Assist the team in reviewing prior-authorization requests for medical necessity and appropriateness
- Identify, develop, and provide orientation and competency development for staff processing and/or reviewing authorizations
- Collaborate with providers (internal and external), clinical staff, and others to timely resolve any utilization management issues
Benefits
- Apply your clinical expertise in meaningful ways as we rapidly expand. You will have the opportunity to design the way we work in the context of an encouraging and loving environment where every person feels uniquely cared for.
- Medical insurance coverage (Medical, Dental, Vision) starting day one of employment
- Work/life balance – we mean it! 17 days of personal time off (PTO), 12 holidays observed annually, and 6 sick days
- Advancement opportunities - We’ve got a track record of hiring and promoting from within, meaning you can create your own path!
- And additional benefits
- Compensation consists of base salary plus bonus.
- WelbeHealth offers a competitive total rewards package that includes a 401(k) match, comprehensive healthcare coverage, and a broad range of additional benefits.
- Actual compensation will be determined based on experience and relevant qualifications.
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
No Education Listed
Number of Employees
251-500 employees
