Registered Nurse Utilization Manager

A company is looking for a Manager, Utilization Management (Remote).

Key Responsibilities

Manage a team of UM Nurse Analysts, guiding workload and supporting team development

Partner with leadership to shape UM content workflows and quality assurance processes

Interpret medical policies to develop clinical decision logic and support NLP model training

Required Qualifications

Bachelor's degree in nursing; must be a Registered Nurse (RN)

At least 4 years of experience in a Utilization Management program

Over two years of team leadership and managerial experience

Experience with digital tools, structured content development, and coding (ICD-10, CPT) preferred

Comfortable working in a tech-enabled, fast-changing environment