Clinical Utilization Review Manager
Hybrid - NYhybridmanager$100K – $148K
Posted today · via Workday
About this role
Position Summary: The Manager of Utilization Management provides daily oversight for Case Management teams (which includes RN’s, Social Workers, and Coordinators). The Manager of Utilization Management is responsible for ensuring high quality, cost-effective, and appropriate allocation of member services, treatments, and resources. The Manager of Utilization Management serves as a resource to Healthfirst’s care management team, members, and outside medical providers. - Oversees utilization management functions which include timely authorizations related to pre-certification, concurrent review, referrals, and other plan services.…
What we'd score you on
reqspace match rubricFive dimensions, recruiter-grade. Upload your resume and we'll generate a written explanation of where you fit and where the gaps are.
1
Skills match
For this role: teams
2
Level fit
This role is manager-level. We check your trajectory against it.
3
Domain experience
Your work in the role's domain matters more than your years total. We weight recent and direct experience.
4
Recency
A skill you used last quarter weighs more than one from five years ago. We grade on recency, not lifetime.
5
Location fit
This role is based in Hybrid - NY. We weight your proximity and willingness to relocate.
Score yourself on this role.
Free · no card · written explanation included
Skills in this role
Pulled from the job description. These are the keywords we'll weight when scoring your fit.
teams
More at Healthfirst
- View →Sr Manager, Clinical UM Operations - AutomationHybrid - NY
- View →Ancillary Services Network Account ManagerNew York, NY
- View →Case Manager Utilization Management II-1Remote - NY
- View →Learning Delivery Specialist – Clinical RNNew York, NY
- View →Field Service Agent - Brooklyn - SpanishBrooklyn, NY
- View →Field Assessment Registered Nurse, Manhattan, NY - $10,000 Sign-On Bonus (Spanish)Bronx, NY