Sr Manager Clinical UM Operations - Hybrid NY

France Cars SAS AAA(2 months ago)

HybridFull TimeSenior$102,600 - $183,430Utilization Management

About this role

The Senior Manager, Clinical Utilization Management (UM) Operations provides strategic and operational leadership for all utilization management functions, overseeing leaders who manage clinicians and coordinators handling medical necessity review, authorizations, and care coordination. The role ensures compliance with state and federal regulations and contractual obligations while driving clinical quality and member-centered outcomes. This position partners across clinical operations, quality, compliance, and provider relations to optimize performance and reporting.

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Required Skills

Utilization Management
Prior Authorization
Concurrent Review
Care Coordination
Regulatory Compliance
Team Leadership
Data Analytics
KPI Reporting
Audit Readiness
Process Improvement

+2 more

Qualifications

Bachelor’s Degree in Nursing, Healthcare Administration, or Related Field
NYS RN

About France Cars SAS AAA

bloomberg.com

Bloomberg is a global leader in financial information and technology, providing data, news, and analytics to financial professionals around the world. The company offers an array of products and services, including the Bloomberg Terminal, which delivers real-time data and insights for trading, investment, and risk management. With a commitment to innovation, Bloomberg combines cutting-edge technology with extensive market expertise to empower financial professionals in making informed decisions.

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