Managing the performance of the utilization management nurse team, the full-time Remote Registered Nurse Utilization Manager will oversee the end-to-end delivery of the UM program, ensuring compliance with service-level agreements and driving continuous improvement while also handling complex case reviews and provider disputes. Key Responsibilities Accountable for UM team performance, including meeting program SLAs and conducting regular performance reviews and coaching sessions Lead ongoing quality assurance activities and manage staffing, scheduling, and case assignments to maintain SLA performance Engage with stakeholders to strengthen communication and ensure alignment on authorization decisions and care strategies Required Qualifications Current, active Registered Nurse (RN) license in good standing 7+ years of utilization management experience, including in risk-based, integrated care models 3+ years of direct people-management experience leading clinical reviewers or UM nurses Experience with inter-rater reliability and quality assurance programs Strong data literacy to utilize analytics for performance improvement