WelbeHealth

Utilization Management RN

WelbeHealth$99K — $131K *
Healthcare
Less than 5 years of experience
Job Overview by Ladders

Qualifications

  • Minimum of three (3) years of relevant clinical nursing experience
  • Preferred experience in PACE (Program of All-Inclusive Care for the Elderly)
  • Two (2) years of supervisory experience
  • Demonstrated ability to mentor and develop team members
  • Strong understanding of utilization management processes

Responsibilities

  • Oversee daily operations of the Utilization Management team
  • Assist team in reviewing prior-authorization requests for appropriateness
  • Identify and develop orientation and competency training for staff
  • Collaborate with internal and external providers to resolve utilization issues
  • Drive continuous improvement of care delivery processes

Benefits

  • Medical insurance coverage (Medical, Dental, Vision)
  • Generous personal time off (17 days PTO and 12 holidays observed)
  • 401K savings plan with company match
  • Opportunities for internal advancement and growth
  • Encouraging work environment focused on individual care
Full Job Description
Our Health Plan Services team plays a critical role in our participant's journey and our Utilization Management team ensures we can provide timely, quality, compliant, and cost-effective care to our participants. By guiding this team, the Utilization Management RN Supervisor drives the continuous improvement of our care delivery processes.

Essential Job Duties:
  • Direct oversight of day-to-day operations within the designated UM team
  • Assist the team in reviewing prior-authorization requests for medical necessity and appropriateness
  • Identify, develop, and provide orientation and competency development for staff processing and/or reviewing authorizations
  • Collaborate with providers (internal and external), clinical staff, and others to timely resolve any utilization management issues

Job Requirements:
  • Minimum of three (3) years of relevant clinical nursing experience
  • Strong preference for prior PACE experience
  • Two (2) years of supervisory experience with demonstrated aptitude to mentor and develop team members

Benefits of Working at WelbeHealth: Apply your expertise in new ways as we rapidly expand. You will have the opportunity to design the way we work in the context of an encouraging and loving environment where every person feels uniquely cared for.
  • Medical insurance coverage (Medical, Dental, Vision)
  • Work/life balance - we mean it! 17 days of personal time off (PTO), 12 holidays observed annually, and sick time
  • 401K savings + match
  • Advancement opportunities - we've got a track record of hiring and promoting from within, meaning you can create your own path!
  • And additional benefits


Compensation consists of base salary plus bonus. WelbeHealth offers a competitive total rewards package that includes a 401(k) match, comprehensive healthcare coverage, and a broad range of additional benefits. Actual compensation will be determined based on experience and relevant qualifications.

Compensation Offering

$99,309.58-$131,088.64 USD

COVID-19 Vaccination Policy

At WelbeHealth, our mission is to unlock the full potential of our vulnerable seniors. In this spirit, please note that we have a vaccination policy for all our employees and proof of vaccination, or a vaccine declination form will be required prior to employment. WelbeHealth maintains required infection control and PPE standards and has requirements relevant to all team members regarding vaccinations.

About WelbeHealth

Industry
Founded
2015

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