Senior Manager leading operations strategy for a fintech company in Mexico, optimizing processes, integrating technology and managing resources effectively.
About the role
- Utilization Review Manager overseeing daily review operations and compliance at Saint Alphonsus in Boise, Idaho. Providing supervisory leadership and collaborating with medical teams for optimal outcomes.
Responsibilities
- Oversee daily utilization review operations, serving as first point of escalation for issue resolution.
- Ensure compliance with payer and regulatory requirements.
- Provide supervisory leadership through scheduling, performance management, and guiding staff development.
- Direct utilization review workflows and medical necessity evaluations.
- Manage denial prevention, expedited appeals, and payer communication to secure authorizations.
- Collaborate closely with Physician Advisors, CRM Managers, and the multidisciplinary team to maintain reporting and optimize departmental processes.
Requirements
- Licensed in the State of Idaho as a Registered Nurse as defined by the Idaho State Board of Nursing.
- BSN required
- 5 or more years of experience in utilization review or case management or similar required.
- 2 or more years of supervisory experience required.
- American Heart Association Basic Life Support for HealthCare Provider (BLS/HCP) certification required
Benefits
- Day 1 Benefits – colleagues are eligible for our plans from their very first day of work.
- Market-competitive pay
- Generous PTO
- Retirement planning and matching
- College savings plans for your family
- Multiple life insurance plans
- Employee Assistance Programs
- Tuition reimbursement
- Educational opportunities
Job title
Job type
Experience level
Salary
Not specified
Degree requirement
Location requirements
Senior Post - Merger Integration Manager at bunch overseeing the integration of acquired fund administration businesses into our operating model for private markets.
Senior Post - Merger Integration Manager at bunch focused on integrating fund administration businesses. Driving operational processes with a strong emphasis on AI tools and project management.
Radio & Satellite Platform Manager overseeing operational support and management of technical aspects. Ensuring reliability and customer satisfaction in platform services.
Staff Supplier Integration Manager responsible for supply chain strategies and supplier integration for melting salt blanket. Overseeing procurement contracts and ensuring project objectives within fusion energy sector.
Case Manager II providing enhanced care management for high - need clients at Family Health Centers of San Diego. Focusing on comprehensive assessments and collaborative care plans to support the medically underserved.
VIP Manager focusing on relationships with VIP customers for online casino and sportsbook. Managing retention strategies and enhancing customer engagement while supporting a dynamic team environment.
Grants Manager overseeing UK and international grants portfolio for the Academy. Supporting strategic priorities for the next generation of researchers.
Creator Manager at Acast working with podcast partners for growth. Focused on strategic development and partner support in the dynamic podcast industry.
Manager responsible for biomethane sales and contracting strategies at Keon. Collaborating with internal teams to optimize and secure contracts while representing Keon at industry events.