Manager of Utilization Management Support

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together.

 

The Manager, Utilization Management (UM) Support is a strategic leadership role responsible for overseeing day-to-day operations within the UM Central support team, ensuring optimal efficiency, accuracy, and compliance with regulatory requirements. This role champions diversity, equity, and inclusion (DEI) by fostering an empowered and engaged team environment. The Manager drives performance through collaborative feedback, continuous improvement initiatives, and cross-functional communication with internal departments, including clinical teams, quality assurance, IT, and network services. Leading with empathy and innovation, cultivating a culture of respect, accountability, and excellence while aligning operational goals with organizational values and health plan objectives.

 

If you are located in PST or MST, you will have the flexibility to work remotely* as you take on some tough challenges

 

Primary Responsibilities:

• Manages and is accountable for professional employees and/or supervisors
• Impact of work is most often at the local or market level
• Performs other duties as assigned

Professional Competencies:

• Sets Team direction, resolves problems and provides guidance
• May oversee work activities of other supervisors
• Working knowledge of PC applications including MS Office Suite
• Ability to use written and oral communication skills
• Ability to read and interpret data
• Skill in writing clear, grammatically correct, easy to use instructional documentation
• Ability to identify learning needs, set goals and seek educational opportunities
• Ability to analyze problems and formulate appropriate plans, solutions, and courses of action
• Knowledge of age specific communication needs with the ability to listen actively and respond to internal and external customers in a timely, competent manner both verbally and nonverbally
• Ability to work with frequent interruptions
• Ability to establish and maintain cooperative working relationships with individuals at all levels of the organization and affiliates
• Ability to maintain confidentiality of patient and all related entity business matters of the organization and its partners
• Ability to manage detail and work with accuracy
• Ability to recognize and act appropriately in situations where patient care needs exceed scope of practice
• Skill in working with a team and the ability to collaborate on projects with colleagues
• Skill in working effectively under deadlines and changing priorities

Skills: 

• Integrates Lean principles, practices and tools to improve operational efficiency, reduce costs and increase customer satisfaction
• Follows written and oral instructions and completes routine tasks independently
• Completes annual compliance training on HIPAA/Privacy/Confidentiality/Non-Discrimination/Harassment/Integrity Statement and signed Agreements
• Ensures confidentiality of patient information following HIPAA guidelines and company policies
• Attends training to meet requirements of the job position and as needed or mandated by company policies and regulations
• Has regular and predictable attendance
• Led and developed supervisory staff overseeing Letter Writers, Appeals, and Peer-to-Peer Support teams within Utilization Management
• Ensured timely, accurate, and compliant communications in accordance with CMS, NCQA, Health Plans, and state regulatory guidelines
• Fostered an inclusive and engaged team culture through mentorship, professional development, and empowerment strategies
• Utilized performance metrics to monitor productivity, turnaround times, and quality, implementing corrective actions as needed
• Facilitated cross-functional collaboration with clinical, legal, IT, and compliance teams to streamline processes and resolve operational issues
• Championed continuous feedback and improvement initiatives to enhance workflow efficiency and team performance
• Maintained audit readiness by overseeing documentation standards, letter content accuracy, and data retention protocols
• Resolved escalated member and provider concerns related to appeals, peer reviews, and denial letters with a solutions-oriented approach
• Promoted psychological safety and open communication to build strong team relationships and reduce turnover
• Proficient in UM systems such as QNXT, TruCare, or GuidingCare, with the ability to identify and address system-related challenges

 

You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

Required Qualifications:

• 3+ years of progressive leadership experience with direct reports
• 2+ years of progressive experience in utilization management
• Solid knowledge of healthcare regulations, utilization review processes
• Proficiency in application of utilization management criteria, such as InterQual or MCG
• Demonstrated analytical, problem-solving, and decision-making skills

Preferred Qualifications:

• Current active licensure as a Licensed Practical Nurse (LPN)
• Effective executive communication, interpersonal, and collaboration skills

 

*All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy.

 

The salary range for this role is $89,800 to $176,700 annually based on full-time employment. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. UnitedHealth Group complies with all minimum wage laws as applicable. In addition to your salary, UnitedHealth Group offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with UnitedHealth Group, you’ll find a far-reaching choice of benefits and incentives. 

 

Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.

 

At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone–of every race, gender, sexuality, age, location and income–deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes – an enterprise priority reflected in our mission.

 

 

UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.

 

UnitedHealth Group is a drug – free workplace. Candidates are required to pass a drug test before beginning employment.