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Director, UM - RN

Imperial Health Holdings • US • published 2026-10-06 07:33:52.817225

Description

**JOB DESCRIPTION** **JOB TITLE:** Director, UM \- RN FLSA STATUS: Exempt **DEPARTMENT:** Utilization Management **REPORTS TO:** Chief Medical Officer **AUTHORITY**: Clinical and non\-clinical staff **JOB SUMMARY:** Responsible for providing operational leadership to the day\-to\-day function of the UM/Prior Authorization and Inpatient Teams. The UM Manager will ensure that the team complies with Federal, State, Health Plan and NCQA requirements **ESSENTIAL JOB FUNCTIONS:** 1\. Collaborating with clinical and non\-clinical personnel providing timely care which complies with generally accepted standards of clinical practice. 2\. Assigns work schedules, delegates reviews, provides direction on review priorities, meets the demands of internal and external partners, and ensures staff achieve performance goals and adherence to company policies. 3\. Ensures that the UM team is properly trained to conduct medical necessity reviews on incoming pre\-service/prior authorization, on routine and expedited referrals requests in compliance with Federal, State, Health Plan and NCQA standards. 4\. Ensures UM team documents on the medical management system timely, all supporting clinical informatio...

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