Demo

Lead Utilization Management Nurse

First Match Services, Inc.
Brook, IL Full Time
POSTED ON 4/14/2025
AVAILABLE BEFORE 5/9/2025

Job Description

Job Description

We have an innovative organization looking to add a Lead Utilization Management Nurse to its team. Their main purpose is to enable physicians to engage, support, and manage new value-based savings and shared-risk models. They deliver timely, turn-key solutions for healthcare providers, health plans and strategic partners.

In this position as the Lead Utilization Management Nurse you will provide expertise in Utilization Management while managing a small team of UM nurses to help ensure that every patient receives the right type of care, at the right time in the right setting, every day! You will also provide hands-on expertise to help implement company strategies and provide oversight of assigned IPA Utilization Management program.

Some other responsibilities include :

  • Conducting monthly client UM Committee meetings
  • Act as a resource for the UM Nurses (first point of contact for clinical clarification / education)
  • Participate in data analysis of utilization metrics
  • Prepare, participate and present summary utilization management reports to UM / QM Committee
  • Much More!

QUALIFICATIONS

  • Bachelor of Science degree (AND or BSD) in Nursing
  • At least 4-5 years of relevant professional experience, including medical management experience in health plans, provider, or MSO settings and quality chart reviews
  • Registered Nurse (RN) with a current and active nursing license to practice in the State of Illinois is required
  • A minimum of three (3) years of responsible leadership experiences in management positions
  • Certified Case Manager (CCM) preferred
  • Knowledge / experience in Medicare / Medicaid and HEDIS criteria is highly desirable
  • Valid Driver's License and vehicle required
  • Ability to travel at least 30% for client meetings within the state required
  • ADDITIONAL DETAILS

  • On-site gym FREE to employees
  • On-site deli
  • Professional Development Opportunities
  • Great base salary with bonus potential
  • Full benefits, 401k and PTO allowance
  • Eligible for consideration of partial work from home status upon completion of probationary period as designated by the direct supervisor.
  • If your compensation planning software is too rigid to deploy winning incentive strategies, it’s time to find an adaptable solution. Compensation Planning
    Enhance your organization's compensation strategy with salary data sets that HR and team managers can use to pay your staff right. Surveys & Data Sets

    What is the career path for a Lead Utilization Management Nurse?

    Sign up to receive alerts about other jobs on the Lead Utilization Management Nurse career path by checking the boxes next to the positions that interest you.
    Income Estimation: 
    $77,596 - $95,368
    Income Estimation: 
    $103,451 - $147,195
    Income Estimation: 
    $140,279 - $184,407
    Income Estimation: 
    $95,686 - $120,121
    Income Estimation: 
    $116,256 - $149,125
    Income Estimation: 
    $114,631 - $139,616
    Income Estimation: 
    $151,081 - $203,854
    Income Estimation: 
    $99,679 - $131,395
    Income Estimation: 
    $140,279 - $184,407
    Income Estimation: 
    $141,315 - $199,204
    Income Estimation: 
    $79,160 - $96,350
    Income Estimation: 
    $103,451 - $147,195
    Income Estimation: 
    $140,279 - $184,407
    Income Estimation: 
    $95,686 - $120,121
    Income Estimation: 
    $116,256 - $149,125
    Income Estimation: 
    $90,669 - $116,273
    Income Estimation: 
    $103,451 - $147,195
    Income Estimation: 
    $140,279 - $184,407
    Income Estimation: 
    $95,686 - $120,121
    Income Estimation: 
    $116,256 - $149,125
    View Core, Job Family, and Industry Job Skills and Competency Data for more than 15,000 Job Titles Skills Library

    Job openings at First Match Services, Inc.

    First Match Services, Inc.
    Hired Organization Address Houston, TX Full Time
    Job Description Job Description We have a client looking to add a full-time, permanent Family Medicine Nurse Practitione...

    Not the job you're looking for? Here are some other Lead Utilization Management Nurse jobs in the Brook, IL area that may be a better fit.

    Travel Nurse RN - Utilization Review - $2,105 per week

    TotalMed Case Management Staffing, Chicago, IL

    Director of Utilization Management

    Universal Health Services, Inc., Forest, IL

    AI Assistant is available now!

    Feel free to start your new journey!