About the Role The UM Trainer is responsible for designing, coordinating, and delivering training programs that support the onboarding, development, and ongoing education of Utilization Management ...
About the Role The UM Trainer is responsible for designing, coordinating, and delivering training programs that support the onboarding, development, and ongoing education of Utilization Management ...
The UM Trainer is responsible for designing, coordinating, and delivering training programs that support the onboarding, development, and ongoing education of Utilization Management team members.
The UM Trainer is responsible for designing, coordinating, and delivering training programs that support the onboarding, development, and ongoing education of Utilization Management team members.
RN Utilization Management - $60/hr - Hamden, CT
Hamden, CT · On-site
$60/hr
Minimum 6 months of Utilization Management (UM) experience * RN License in CT Description: We are looking for a dedicated RN with Utilization Management experience for a 12-week contract in Hamden ...
RN Utilization Management - $60/hr - Hamden, CT
Hamden, CT · On-site
$60/hr
Minimum 6 months of Utilization Management (UM) experience * RN License in CT Description: We are looking for a dedicated RN with Utilization Management experience for a 12-week contract in Hamden ...
Clinical Manager The Clinical Manager of the Utilization Management (UM) Department oversees the ... Minimum three (3) years of supervisory/management experience preferred. Minimum of five (5) years ...
Clinical Manager The Clinical Manager of the Utilization Management (UM) Department oversees the ... Minimum three (3) years of supervisory/management experience preferred. Minimum of five (5) years ...
Job Summary Supervises daily Utilization Management (UM) program operations. This position reports to a Manager of Utilization Management in either Prospective, Retrospective, or Appeals and ...
Job Summary Supervises daily Utilization Management (UM) program operations. This position reports to a Manager of Utilization Management in either Prospective, Retrospective, or Appeals and ...
Job Summary Supervises daily Utilization Management (UM) program operations. This position reports to a Manager of Utilization Management in either Prospective, Retrospective, or Appeals and ...
Job Summary Supervises daily Utilization Management (UM) program operations. This position reports to a Manager of Utilization Management in either Prospective, Retrospective, or Appeals and ...
Travel RN Utilization Management (RN UM)
Camden, ME · On-site
$5.3K - $6.2K/wk
Travel RN - Utilization Management (RN UM) - Camden, ME (Skilled Nursing & Rehab) Immediate Opening - Travel Contract (14 Weeks) Seeking an experienced RN for a Utilization Management (UM) travel ...
Quick apply
Travel RN Utilization Management (RN UM)
Camden, ME · On-site
$5.3K - $6.2K/wk
Travel RN - Utilization Management (RN UM) - Camden, ME (Skilled Nursing & Rehab) Immediate Opening - Travel Contract (14 Weeks) Seeking an experienced RN for a Utilization Management (UM) travel ...
Clinical Utilization Management Pharmacist
$125K - $149K/yr
Job Summary Job Summary Under the direction of the Pharmacy Utilization Management (UM) Supervisor, the Clinical Pharmacist is responsible for reviewing, processing and managing the daily caseload of ...
Clinical Utilization Management Pharmacist
$125K - $149K/yr
Job Summary Job Summary Under the direction of the Pharmacy Utilization Management (UM) Supervisor, the Clinical Pharmacist is responsible for reviewing, processing and managing the daily caseload of ...
Be Seen First
Supervisor, Utilization Management & Appeals
Tampa, FL · Remote
$50 - $60/hr
The Supervisor provides guidance and oversight to UM nurses, supports complex case preparation ... Competencies: * Utilization management oversight * Medical necessity * Clinical operations ...
Quick apply
Be Seen First
Supervisor, Utilization Management & Appeals
Tampa, FL · Remote
$50 - $60/hr
The Supervisor provides guidance and oversight to UM nurses, supports complex case preparation ... Competencies: * Utilization management oversight * Medical necessity * Clinical operations ...
Clinical Utilization Management Pharmacist
Canton, MA · On-site
$125K - $149K/yr
Job Summary Job Summary Under the direction of the Pharmacy Utilization Management (UM) Supervisor, the Clinical Pharmacist is responsible for reviewing, processing and managing the daily caseload of ...
Clinical Utilization Management Pharmacist
Canton, MA · On-site
$125K - $149K/yr
Job Summary Job Summary Under the direction of the Pharmacy Utilization Management (UM) Supervisor, the Clinical Pharmacist is responsible for reviewing, processing and managing the daily caseload of ...
RN UM
Franklin, NH · On-site
Coordinate and perform utilization management (UM) activities, including admission, continued stay, and discharge reviews in accordance with facility policies and payer guidelines. * Assess medical ...
RN UM
Franklin, NH · On-site
Coordinate and perform utilization management (UM) activities, including admission, continued stay, and discharge reviews in accordance with facility policies and payer guidelines. * Assess medical ...
Utilization Review Nurse
Canton, MA · On-site
$55 - $60/hr
Perform outpatient utilization management (UM) and medical necessity reviews for prior authorization and precertification requests. * Review clinical documentation and determine benefit eligibility ...
Utilization Review Nurse
Canton, MA · On-site
$55 - $60/hr
Perform outpatient utilization management (UM) and medical necessity reviews for prior authorization and precertification requests. * Review clinical documentation and determine benefit eligibility ...
Clinical Utilization Management Pharmacist
Canton, MA · On-site
$125K - $149K/yr
Job Summary Job Summary Under the direction of the Pharmacy Utilization Management (UM) Supervisor, the Clinical Pharmacist is responsible for reviewing, processing and managing the daily caseload of ...
Clinical Utilization Management Pharmacist
Canton, MA · On-site
$125K - $149K/yr
Job Summary Job Summary Under the direction of the Pharmacy Utilization Management (UM) Supervisor, the Clinical Pharmacist is responsible for reviewing, processing and managing the daily caseload of ...
Support the UM Director and Supervisor in data collection and analysis. * Creates and manage comprehensive reports on utilization and productivity and performance trends. * Reviews the human resource ...
Support the UM Director and Supervisor in data collection and analysis. * Creates and manage comprehensive reports on utilization and productivity and performance trends. * Reviews the human resource ...
Support the UM Director and Supervisor in data collection and analysis. * Creates and manage comprehensive reports on utilization and productivity and performance trends. * Reviews the human resource ...
Support the UM Director and Supervisor in data collection and analysis. * Creates and manage comprehensive reports on utilization and productivity and performance trends. * Reviews the human resource ...
MANAGER OF UTILIZATION REVIEW
Hudson, OH · On-site
The Utilization Management (UM) RN Manager is responsible for the day-to-day leadership ... Prior formal leadership experience required; two or more years of supervisory or management ...
MANAGER OF UTILIZATION REVIEW
Hudson, OH · On-site
The Utilization Management (UM) RN Manager is responsible for the day-to-day leadership ... Prior formal leadership experience required; two or more years of supervisory or management ...
The Utilization Management (UM) RN Manager is responsible for the day-to-day leadership ... Prior formal leadership experience required; two or more years of supervisory or management ...
The Utilization Management (UM) RN Manager is responsible for the day-to-day leadership ... Prior formal leadership experience required; two or more years of supervisory or management ...
The Utilization Management (UM) RN Manager is responsible for the day-to-day leadership ... Prior formal leadership experience required; two or more years of supervisory or management ...
The Utilization Management (UM) RN Manager is responsible for the day-to-day leadership ... Prior formal leadership experience required; two or more years of supervisory or management ...
Job Summary The Director of Utilization Management (UM) is responsible for leading and managing the Utilization Management (UM) functions at Northeast Georgia Medical Center. This position plays a ...
Job Summary The Director of Utilization Management (UM) is responsible for leading and managing the Utilization Management (UM) functions at Northeast Georgia Medical Center. This position plays a ...
Job Summary The Director of Utilization Management (UM) is responsible for leading and managing the Utilization Management (UM) functions at Northeast Georgia Medical Center. This position plays a ...
Job Summary The Director of Utilization Management (UM) is responsible for leading and managing the Utilization Management (UM) functions at Northeast Georgia Medical Center. This position plays a ...
Utilization Management Um Supervisor information
See salary details
$39K - $50.7K
9% of jobs
$59.3K is the 25th percentile. Wages below this are outliers.
$50.7K - $62.4K
22% of jobs
$62.4K - $74K
11% of jobs
The median wage is $81.2K / yr.
$74K - $85.7K
14% of jobs
$85.7K - $97.4K
12% of jobs
$104.7K is the 75th percentile. Wages above this are outliers.
$97.4K - $109.1K
13% of jobs
$109.1K - $120.8K
13% of jobs
$120.8K - $132.5K
5% of jobs
$132.5K - $144.1K
2% of jobs
$144.1K - $155.8K
0% of jobs
$155.8K - $167.5K
0% of jobs
$39K
$91K
$167.5K
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Job description
About the Role
- Oversee Training Design amp; Delivery
- Create consolidated training materials and framework for onboarding of CRS (Case Review Specialist) roles
- Ensure that training materials are customized to address key operational and system variances such as UM Applications, Mainland v Puerto Rico, and Phone vs Non-Phone Roles
- Plan training agendas and approach to include virtual delivery, validation of learning, and schedules and materials
- Support continuous improvement of training plans and materials based on feedback from new hires and long-term success (measured by metrics including quality, productivity and retention)
- Work with operations and HR to schedule training sessions for new hires
- Ensure new hire capacity is appropriately planned to align with prioritized operational needs
- Develop “retraining” and “advanced training” materials for existing employees over time to support change management, quality improvement, and upskilling
- Performance Monitoring amp; Continuous Improvement
- Measure training effectiveness through assessments, quality outcomes, learner feedback, and operational performance metrics.
- Analyze training results and identify opportunities for curriculum improvements.
- Track training completion and maintain training records.
- Recommend innovative learning solutions and process improvements.
- Quality amp; Compliance Education
- Partner with Quality and Compliance teams to identify training opportunities based on audit findings, trends, and performance metrics.
- Ensure training content aligns with NCQA, URAC, CMS, HIPAA, and client requirements.
- Reinforce compliance expectations and documentation standards across all UM functions.
- Provide remediation training when performance gaps are identified.
- Collaboration amp; Stakeholder Partnership
- Collaborate with Operations, Quality, Clinical, Customer Support, Product, and Compliance teams to ensure training remains aligned with business needs.
- Collaborate with HR to align employee start dates with training schedules and team capacity needs and priorities for onboarding
- Collaborate with HR and UM quality leadership to understand employee feedback during coaching and exit interviews that may lead to insights and continuous improvement for training materials and processes
- Participate in cross-functional initiatives and process improvement projects.
- Serve as a subject matter resource for UM workflows, systems, and best practices
- Associate or bachelor’s degree preferred, particularly in: Healthcare Administration, Health Information Management, Business Administration or a related field. Relevant experience may be considered in lieu of a degree.
- Typical years of experience are a minimum of 3–5 years in healthcare operations, utilization management, prior authorization, or related healthcare experience.
- Minimum of 1–2 years of training, coaching, mentoring, quality, or leadership experience preferred.
- Experience creating training materials and facilitating adult learning programs preferred.
- Strong presentation and facilitation skills.
- Excellent verbal and written communication skills.
- Strong organizational and project management abilities.
- Ability to explain complex concepts in a clear and engaging manner.
- Strong analytical and problem-solving skills.
- Ability to coach and develop employees through various learning styles.
- High attention to detail and commitment to accuracy.
- Ability to manage competing priorities and drive results through others.
- Systems/Tools: MS Office Suite proficient. Experience with call center platforms, case management systems, and workforce management tools preferred
- Bilingual (English and Spanish) preferred
- Ability to remain seated for extended periods while working at a computer workstation and managing a high volume of inbound phone calls.
- Workspace must be PHI‑compliant, ensuring privacy and always safeguarding protected health information. This includes:
- A private environment where conversations cannot be overheard
- Secure handling of all electronic and written information
- Compliance with HIPAA and company privacy standards
- Reliable internet connectivity, power supply, and equipment capable of supporting sustained call volume and system usage.
- Ability to maintain focus and productivity in a fast‑paced, high‑volume operational environment.
OncoHealth is committed to remote, hybrid or in office work options. The majority of the team will be remote or in hybrid work arrangements with offices in Atlanta, GA and Guaynabo, PR. We are open to employees nationwide but work primarily in the Eastern and Central Time Zones.
Our Culture
Taking ownership of quick action, critically thinking through the needs, and working well with others are key competencies of team member success. Our leadership is dedicated to building a culture based on respect, clinical excellence, innovation – all with a focused mission of putting patients first!
We offer a full benefit package on your first day, along with a company bonus. You may visit or work from our very modern and engaging offices, and experience a fun, collaborative environment where social activities and community events matter. We enjoy being together!
The Opportunity
The cost of cancer related medical services and prescription drugs in the United States is expected to reach $246 billion by 2030. OncoHealth has enjoyed rapid growth over the past 3 years and seeks smart, collaborative people to join its team. We have just under 250 team members, so we can move swiftly but precisely to the market needs of our customers. Strongly backed financially by Arsenal Capital Partners amp; McKesson Corporation, we remain in an investment and growth mode. This means we are open-minded to how we get the work done – now is the perfect time to talk to us!
Our Current Solutions
Through the use of OncoHealth's utilization management system, OneUM, our customers can use a single e-Prior Authorization portal for all oncology drug request and treatments. Our system improves quality of care, reduces provider abrasion and gives health plans visibility into the total cost of oncology treatment.
OncoHealth offers Oncology Insights Pro, an analytic software solution that enables health plans to use data and analytics to improve oncology programs. Using real world data, our engineers normalize data to create analytic dashboards with drill down compatibilities. The data is the paired with expert guidance providing the strategies an insight needed to keep up with the continuing evolving cancer treatment landscape.
OncoHealth offers Pharmacy Consulting services to health plans and pharmaceutical companies. New cancer treatments are entering the market at an unrelenting pace. Since 2018, the FDA approved 121 new cancer applications including 49 novel cancer drug entities. Our Board-Certified Oncology Pharmacologists can help health plans update drug policies, offer utilization management and formulary advice, and development training for staff.
OncoHealth's latest offering is Iris, a digital telehealth platform that delivers personalized, oncology-specific support to navigate the physical symptoms and emotional challenges caused by cancer and cancer treatment. Powered by technology, staffed 24X7, and delivered with empathy, Iris allows patients to connect with trained oncology experts and receive personalized, oncology-specific telehealth support.