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Utilization Management (UM) Market Operations Manager at CareSource - ApplyBlast

Utilization Management (UM) Market Operations Manager

CareSource

2 months ago

3.5 on Glassdoor

Remote

Full Time

Manager

0 applicants

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About this role

The Utilization Management (UM) Market Operations Manager oversees operational activities for UM and Appeals, developing policies, managing metrics, ensuring regulatory compliance, and leading process improvement initiatives. This remote, full‑time role requires a registered nurse or licensed psychologist with extensive UM and managed care experience.

Responsibilities

Oversee operational activities for Utilization Management and Appeals
Develop and maintain policies, procedures, and regulatory compliance documentation
Drive process improvement and change management initiatives across departments

Skills

Qualifications

Associate Degree in NursingAdvanced Degree in PsychologyRegistered Nurse (RN) licensureLicensed PsychologistSix Sigma certification

About CareSource

caresource.com

Headquarters

Dayton, Ohio, United States

Company Size

1001-5000 employees

Founded

1989

View Profile

CareSource is a nonprofit managed care organization that provides health insurance plans and related healthcare services, primarily through Medicaid, Medicare, and Marketplace offerings. The company works with members, providers, and government partners to deliver access to medical, behavioral health, and care management services in the health insurance industry.