Massachusetts Licensed UM Supervisor

A company is looking for a UM Supervisor, Medicare and Duals.

Key Responsibilities

Provide leadership and oversight of utilization management functions for Medicare Advantage and One Care / SCO Dual populations

Supervise a team of clinicians and non-clinical support staff, ensuring compliance with regulatory requirements

Monitor team performance and facilitate collaboration to promote continuous improvement and member satisfaction

Required Qualifications

Active Registered Nurse (RN) licensure, with Massachusetts RN License required upon hire

Minimum 5-7 years of utilization management experience in a health plan / managed care setting

At least 2 years of supervisory experience preferred

Experience with integrated Medicare / Medicaid programs such as One Care / SCO or similar models preferred

Knowledge of Medicare Advantage programs is beneficial