- 5-7 years of UM experience, preferably in a UM leadership capacity
- Must have MA experience and knowledge of compliance for ODAG, letters, and audit protocols.
- Knowledge of Medicaid and Commercial (URAC) a plus
- Must have successfully worked and or implemented in a plan that has automated authorizations with associated best practice knowledge
- Must have knowledge of InterQual-IQCI certification preferred
- Must be familiar with UM best practices and workflow and have consultative skills with ability to lead key strategic deliverables
- Must have knowledge of the AssureCare platform and how UM best practices are deployed
- Familiarity with business rules to automate UM workflow and automation
- Familiarity with the development of UM business requirements
AssureCare® is an equal opportunity employer that is committed to diversity and inclusion in the workplace. We prohibit discrimination and harassment of any kind based on race, color, sex, religion, sexual orientation, national origin, disability, genetic information, pregnancy, or any other protected characteristic as outlined by federal, state, or local laws.
This policy applies to all employment practices within our organization, including hiring, recruiting, promotion, termination, layoff, recall, leave of absence, compensation, benefits, training, and internship. AssureCare® makes hiring decisions based solely on qualifications, merit, and business needs at the time. Furthermore, the Company will make reasonable accommodations for qualified individuals with known disabilities unless doing so would result in an undue hardship.