Job DescriptionThe Manager, Utilization Management Education & Development is responsible for leading the strategic development, implementation, and evaluation of educational programs that support a centralized, system-wide Utilization Management (UM) department. This position oversees clinical education, onboarding, competency management, regulatory training, professional development, workflow standardization, and adoption of innovative technologies to ensure excellence in utilization management practices across the health system
Responsibilities- Lead the strategic planning, development, and execution of utilization management education programs, including workforce development, succession planning, competency improvement initiatives, and performance management of assigned staff.
- Lead the design, implementation, maintenance, and evaluation of standardized onboarding, education, competency, and professional development programs for centralized utilization management operations, developing educational resources and learning solutions that promote workforce effectiveness, regulatory compliance, operational excellence, and measurable performance improvement.
Lead educational initiatives related to utilization management regulations, payer requirements, accreditation standards, medical necessity determination, authorization processes, and utilization review practices. Monitor regulatory, accreditation, and payer changes
Qualifications- Minimum of five (5) years of Utilization Management, Case Management, Care Coordination, or Revenue Cycle
- Minimum of two (2) years of progressive leadership or management experience
- Experience developing and delivering education, training, or competency programs
Education: Bachelor's Degree Required
Experience working with regulatory and payer requirements within an acute care environment
