Unlocking the full potential of our most vulnerable seniors.
Utilization Management RN
Location
United States
Posted
2 days ago
Salary
$99.3K - $131.1K / year
Seniority
Mid Level
No structured requirement data.
Job Description
Utilization Management RN
WelbeHealth
Role Description 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 drives the continuous improvement of our care delivery processes. - 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 Qualifications - Minimum of three (3) years of relevant clinical nursing experience - Strong preference for prior PACE experience - Two (2) years of supervisory experience with demonstrated aptitude to mentor and develop team members Benefits - Apply your expertise in new ways as we rapidly expand in an encouraging and loving environment - Medical insurance coverage (Medical, Dental, Vision) - Work/life balance - 17 days of personal time off (PTO), 12 holidays observed annually, and sick time - 401K savings + match - Advancement opportunities - track record of hiring and promoting from within - Additional benefits Compensation Offering $99,309.58 — $131,088.64 USD COVID-19 Vaccination Policy At WelbeHealth, our mission is to unlock the full potential of our vulnerable seniors. In this spirit, please note that we have a vaccination policy for all our employees and proof of vaccination, or a vaccine declination form will be required prior to employment. WelbeHealth maintains required infection control and PPE standards and has requirements relevant to all team members regarding vaccinations. Our Commitment to Diversity, Equity and Inclusion At WelbeHealth, we embrace and cherish the diversity of our team members, and we're committed to building a culture of inclusion and belonging. We're proud to be an equal opportunity employer. Beware of Scams Please ensure your application is being submitted through a WelbeHealth sponsored site only. Our emails will come from @welbehealth.com email addresses. You will never be asked to purchase your own employment equipment. You can report suspected scam activity to fraud.report@welbehealth.com.
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