Description
The Utilization Management Manager manages front-end prior authorizations and in-house concurrent review authorizations for ScionHealth patients. The role reviews prospective, retrospective, and concurrent medical records; coordinates with referring hospitals, case management, business development, facility administration, and managed-care payors; prepares medical-necessity appeals; documents authorization information; and supports quality improvement and operational excellence. The position requires postsecondary nursing education or an associate’s degree in healthcare, with a bachelor’s degree preferred, and at least three years of healthcare experience, with prior managed-care, case-management, utilization-review, or discharge-planning experience preferred.
