Utilization Review Supervisor

The Utilization Review Supervisor oversees third-party payer Utilization Review and denial management processes, coordinating front-end to back-end initiatives including authorization appeals and compliance protocols. This role involves supervising providers, analyzing clinical denials, and serving as a liaison between Case Management, Business Office, and Coding teams to ensure timely tracking and follow-up. The position also requires participating in committee meetings, conducting audits, and developing process improvement plans to enhance insurance authorization and denial prevention strategies.