Supervisor, Utilization Management Support

Job not on LinkedIn

🔥 1 minute ago

🇺🇸 United States – Remote

💵 $58k - $80k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

👻 Ghost score 0%

What it means: the chance that no one is really hiring for this job.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

Apply Now

Find Similar Remote Jobs

📊 Check your resume score for this job

Improve your chances of getting an interview by checking your resume score before you apply.

Upload Resume

Devoted Health

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

Founded 2017

🏥 Healthcare

⚕️ Healthcare Insurance

🧘 Wellness

Healthcare • Healthcare Insurance • Wellness

Devoted Health is a healthcare company that offers Medicare Advantage plans designed to provide comprehensive health coverage with added benefits like dental, eyewear, gym memberships, and prescription drugs at competitive rates. The company emphasizes member support and service, ensuring that clients can easily navigate their benefits and access needed healthcare services. Devoted Health is committed to helping customers save money and enhance their health and wellness through a complete package of benefits and support.

📋 Description

• Lead, coach, and develop Utilization Management Coordinator staff • Monitor productivity, accuracy, performance, and provide operational and administrative support • Direct daily prior authorization operations, including triaging and entering PA requests • Contact hospitals and provider offices to obtain clinical documentation • Ensure requests are documented, routed, and prepared for clinical review and determination • Oversee clinical reviews and peer-to-peer scheduling between providers and Medical Directors • Communicate clinical decisions to providers • Manage required documentation, RFI work, and EHR access workflows • Plan and coordinate team work to meet measurable goals, deadlines, service levels, and regulatory turnaround requirements • Monitor work queues, daily census checks, and operational metrics • Identify obstacles, solve problems, and improve workflow efficiency and compliance with CMS, Medicare Advantage, and internal UM policies • Own the team’s Utilization Management AI workflows across building, execution, implementation, performance monitoring, and refinement • Define and track AI-process quality metrics, interpret data, and make iteration decisions with AI Enablement Partners • Ensure local governance and adherence to AI use policies • Collaborate with clinical leadership, provider relations, claims, and other internal teams on UM operations, care transitions, and case follow-up

🎯 Requirements

• 3+ years of utilization management or prior authorization experience • 1+ year of prior leadership or supervisory experience required • Experience in Medicare Advantage or managed care • Knowledge of prior authorization workflows, clinical review processes, and regulatory requirements (e.g., Medicare Advantage) • Strong organizational, communication, and operational management skills • Excellent problem-solving and analytical skills • Experience in a fast-paced, high-volume environment • Proficiency with healthcare systems, EHRs, and reporting tools • Experience driving technology-enabled workflow improvements, particularly with AI/LLM tools • Experience with Intake, authorization, or clinical coordination processes • Familiarity with UM or case management workflows

🏖️ Benefits

• Employer sponsored health, dental and vision plan with low or no premium • Generous paid time off • $100 monthly mobile or internet stipend • Stock options for all employees • Bonus eligibility for all roles excluding Director and above • Parental leave program • 401K program