Manager - Utilization Management (RN)

The Manager of Utilization Management (UM) is responsible for the operational leadership, compliance oversight, and performance management of Utilization Management programs across assigned contracts and lines of business. This role ensures UM activities are delivered in accordance with contractual requirements, accreditation standards (e.g., URAC), regulatory obligations, and evidence-based medical necessity criteria. The Manager oversees UM staff and workflows related to prior authorization, c...