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Sr. Manager-Utilization Management
JOB SUMMARY: Responsible for managing clinical and nonclinical team members. May oversee complex case management, concurrent review, prior authorization, call center and or letter teams. Identifies, implements, and evaluates relevant performance metrics that allow for objective evaluation of staff and/or departmental performance. Responsible for monitoring and facilitating the attainment of performance metrics to meet departmental expectations for productivity and quality. Responsible for managing staffing requirements for daily workload and auditing of letters to comply with all regulatory requirements. Complete deliverables within established timelines. Responsible to ensure the auditing of staff mo
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