Manager, Utilization Management Nursing

Become a part of our caring community The Manager, Utilization Management Nursing utilizes clinical nursing skills to support the coordination, documentation and communication of medical services and/or benefit administration determinations. The Manager, Utilization Management Nursing works within specific guidelines and procedures; applies advanced technical knowledge to solve moderately complex problems; receives assignments in the form of objectives and determines approach, resources, schedules and goals. The Manager, Utilization Management Nursing uses clinical knowledge, communication skills, and independent critical thinking skills towards interpreting criteria, policies, and procedures to provide the best and most appropriate treatment, care or services for members. Coordinates and communicates with providers, members, or other parties to facilitate optimal care and treatment. Decisions are typically related to resources, approach, and tactical operations for projects and initiatives involving own departmental area. Requires cross departmental collaboration, and conducts briefings and area meetings; maintains frequent contact with other managers across the department. Use your skills to make an impact Required Qualifications Active Licensed Registered Nurse (RN) in Virginia or enhanced compact license, (eNLC) with no disciplinary action Minimum 2 years of team lead and/or project lead experience Minimum 2 years progressive clinical experience preferably in an acute care, skilled or rehabilitation setting Intermediate to Advanced knowledge using Microsoft Office Word, Excel, PowerPoint, navigating multiple systems and platforms and ability to troubleshoot and resolve basic technical difficulties in a remote environment. Ability to work independently under general instructions and with a team Preferred Qualifications Bachelor's Degree Prior supervisory experience which may include interviewing, hiring, training, performance evaluation, coaching and up to termin