[Hiring] Utilization Management Lead @Impact Advisors

Role Description

The Utilization Review (UR) / Utilization Management (UM) Lead is responsible for day-to-day leadership of the utilization management program for an assigned healthcare client. The role oversees:

• Concurrent review
• Continued-stay review
• Admission and level-of-care status
• Retrospective review
• Related appeals

The UM Lead improves review productivity and turnaround times, reduces authorization and medical-necessity denials, and supports length-of-stay and throughput goals through:

• Operational management
• Performance monitoring
• Practical process improvement

Qualifications

• Bachelor's degree in Healthcare Administration, Nursing, Business Administration, Public Health, or a related field.
• 7+ years of experience in healthcare operations, utilization management, care management, revenue cycle, or performance improvement.
• 3+ years of leadership experience managing operational teams, transformation initiatives, or consulting engagements.
• Strong understanding of utilization management operations, patient throughput, care coordination, and healthcare reimbursement.
• Experience leading operational improvement initiatives within provider, payer, or consulting environments.
• Strong analytical, project management, and stakeholder engagement skills; able to manage competing priorities.

Requirements

• Master's degree in Healthcare Administration (MHA), Business Administration (MBA), Public Health (MPH), Nursing, or a related field (preferred).
• Consulting experience supporting hospitals, health systems, physician groups, or health plans (preferred).
• Experience with denials management, revenue cycle optimization, and patient flow improvement initiatives (preferred).
• Familiarity with InterQual®, MCG, Epic, Cerner, or other utilization management and care management platforms (preferred).
• Registered Nurse (RN) license preferred but not required.

Benefits

• Eligible for an annual performance bonus for salaried positions.
• Additional benefits and perks may also be available, depending on the position and employment terms.

Company Description

At Impact Advisors, we cultivate a caring, fun, honest, and autonomous work environment. Our success stems from our associates' dedication and a shared mission to create a “Positive Impact.” We embrace diversity and inclusion, fostering an environment where all employees feel valued and empowered.