Loyola Medicine

Utilization Management RN

Loyola Medicine(1 month ago)

Des Moines, IA, IowaOnsiteFull TimeManager$70,743 - $95,309 (estimated)Utilization Management
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About this role

The UM Lead oversees daily operations of the Utilization Management department, serving as the primary escalation point and partnering with clinical and administrative teams. The role supports clinical review processes, payer interactions, and staff development while collaborating with the Director of Care Coordination/Case Management.

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Required Skills

  • Leadership
  • Delegation
  • Staff Management
  • Medical Review
  • Appeals Management
  • Payer Relations
  • Clinical Documentation
  • Precertification
  • Communication
  • Coaching

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Qualifications

  • Bachelor’s Degree
  • Registered Nurse License (Iowa)
  • Utilization Management Certification (Preferred)

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