Talent.com
Utilization Management Nurse Supervisor
Utilization Management Nurse SupervisorIntegra Partners • Troy, MI, US
Utilization Management Nurse Supervisor

Utilization Management Nurse Supervisor

Integra Partners • Troy, MI, US
job_description.job_card.30_days_ago
serp_jobs.job_preview.job_type
  • serp_jobs.job_card.full_time
  • serp_jobs.filters_job_card.quick_apply
job_description.job_card.job_description

The Utilization Management (UM) Nurse Supervisor is responsible for providing direct leadership and oversight to the UM nursing team.

This role ensures team performance, accountability, and professional development by conducting regular 1 :

  • 1s, managing performance reviews, and driving compliance with organizational, state, and federal requirements.
  • The Supervisor balances hands-on operational responsibilities with leadership duties, serving as both a mentor and performance manager for frontline staff.

Salary :

  • $75,000.00 / Annually  JOB QUALIFICATIONS : KNOWLEDGE / SKILLS / ABILITIES   The UM Nurse Team Lead’s responsibilities include but are not limited to : Provide day-to-day supervision of UM nurses, ensuring productivity, accuracy, and adherence to policies and processes.
  • Conduct regular 1 :

  • 1s, coaching sessions, and performance evaluations to support staff growth and accountability.
  • Lead daily / weekly huddles, communicate priorities, and set expectations for performance and timeliness.
  • Serve as first point of escalation for staff questions, operational challenges, or case-related concerns.
  • Promote a culture of collaboration, accountability, and continuous improvement.
  • Monitor team productivity, timeliness, and quality of work through reporting and audits.
  • Take accountability for overall team performance, escalating issues as needed to the UM Clinical Manager.
  • Ensure compliance with all regulatory, contractual, and accreditation standards (CMS, NCQA, state-specific requirements).
  • Support audit preparation, quality initiatives, and corrective action plans as needed.
  • Oversee case assignment, queue management, and authorization workflows to ensure timely completion.
  • Perform authorization reviews as needed, utilizing federal / state mandates, plan benefit language, and medical necessity criteria (e.g., InterQual, CMS, health plan policies).
  • Review and process clinical and administrative appeals; coordinate with Medical Director when required.
  • Generate and review daily / weekly reporting on productivity and case timeliness.
  • Manage team calendars, including PTO, planned outages, and rotation schedules.
  • Participate in user acceptance testing (UAT), system / process improvements, and special projects.
  • Act as liaison between UM staff and UM leadership to ensure clear communication of priorities, policies, and workflow changes.
  • Collaborate with internal partners (e.g., Provider Relations, Quality) to resolve escalations and address utilization management issues.
  • Represent UM nursing team in internal meetings and external stakeholder interactions as directed.
  • Remote work environment with expectations for timely communication and responsiveness.
  • Must be able to handle confidential and sensitive information in compliance with company policies and regulations.
  • Flexibility to adapt to changing priorities, systems, and workflows in a fast-paced environment.
  • EDUCATION :

  • Active, unrestricted Registered Nurse, Licensed Vocational Nurse, or Licensed Practical Nurse license EXPERIENCE : Minimum 3 years of nursing experience in acute, outpatient, or managed care setting.
  • Minimum 2 years of utilization management experience in a payer or managed care environment.
  • Strong understanding of utilization review, authorizations, and appeals processes.
  • Excellent verbal / written communication and organizational skills.
  • Experience with Medicare and Medicaid requirements.
  • Familiarity with DMEPOS authorization and appeals processes.
  • Knowledge of medical necessity criteria (InterQual, CMS, health plan policies).
  • Prior leadership, supervisory, or team lead experience in a UM setting.
  • Benefits Offered Competitive compensation and annual bonus program 401(k) retirement program with company match Company-paid life insurance Company-paid short term disability coverage (location restrictions may apply) Medical, Vision, and Dental benefits Paid Time Off (PTO) Paid Parental Leave Sick Time Paid company holidays and floating holidays Quarterly company-sponsored events Health and wellness programs Career development opportunities Remote Opportunities We are actively seeking new colleagues in :

  • Arizona, Colorado, Connecticut, Florida, Georgia, Idaho, Illinois, Kentucky, Massachusetts, Michigan, North Carolina, New Jersey, New York, Ohio, Pennsylvania, South Carolina, Tennessee, Texas, Virginia, Vermont, and Washington.
  • Our Story Founded in 2005, Integra Partners is a leading national durable medical equipment, prosthetic, and orthotic supplies (DMEPOS) network administrator.
  • Our mission is to improve the quality of life for the communities we serve by reimagining access to in-home healthcare.
  • We connect Payers, Providers, and Members through innovative technology and streamlined workflows affording Members access to top local Providers and culturally competent care.
  • By focusing on transparency, accountability, and adaptability, we help deliver better health outcomes and more efficient management of complex healthcare benefits.
  • Integra Partners is a wholly owned subsidiary of Point32Health.
  • With a location in Michigan plus a remote workforce across the United States, Integra has a culture focused on collaboration, teamwork, and our values :

  • One Team, Drive Results, Push the Boundaries, Value Others, and Build Community.
  • We’re looking for energetic, talented, and dedicated individuals to join our team.
  • See what opportunities we have available; there may be a role for you to engage in a challenging yet rewarding career in healthcare.
  • We look forward to learning more about you.
  • Integra Partners is an equal opportunity employer.
  • We are committed to providing reasonable accommodations and will work with you to meet your needs.
  • If you are a person with a disability and require assistance during the application process, please don’t hesitate to reach out.
  • We celebrate our inclusive work environment and welcome members of all backgrounds and perspectives.
  • Powered by JazzHR
  • serp_jobs.job_alerts.create_a_job

    Utilization Management Nurse • Troy, MI, US

    Job_description.internal_linking.related_jobs
    Travel Nurse RN - ICU - Intensive Care Unit

    Travel Nurse RN - ICU - Intensive Care Unit

    Host Healthcare • Mount Clemens, MI, US
    serp_jobs.job_card.full_time
    Host Healthcare is seeking a travel nurse RN ICU - Intensive Care Unit for a travel nursing job in Mount Clemens, Michigan. Job Description & Requirements.Pay package is based on 12 hour shifts ...serp_jobs.internal_linking.show_more
    serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted
    Travel Nurse RN - PCU - Progressive Care Unit

    Travel Nurse RN - PCU - Progressive Care Unit

    Aequor Healthcare • Mount Clemens, MI, US
    serp_jobs.job_card.full_time
    Aequor Healthcare is seeking a travel nurse RN PCU - Progressive Care Unit for a travel nursing job in Mount Clemens, Michigan. Job Description & Requirements.All positions require at least two ...serp_jobs.internal_linking.show_more
    serp_jobs.last_updated.last_updated_variable_hours • serp_jobs.job_card.promoted • serp_jobs.job_card.new
    Travel Nurse RN - Labor and Delivery

    Travel Nurse RN - Labor and Delivery

    E-SolHealth • Rochester, MI, US
    serp_jobs.job_card.full_time
    E-SolHealth is seeking a travel nurse RN Labor and Delivery for a travel nursing job in Rochester, Michigan.Job Description & Requirements. Proficiency in labor, postpartum, and special care.Cer...serp_jobs.internal_linking.show_more
    serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted
    Travel Nurse RN - Case Management - $2,606 per week

    Travel Nurse RN - Case Management - $2,606 per week

    First Connect Health • Warren, MI, United States
    serp_jobs.job_card.full_time
    First Connect Health is seeking a travel nurse RN Case Management for a travel nursing job in Warren, Michigan.Job Description & Requirements. Facility name- Henry Ford Health System.Location- 1180...serp_jobs.internal_linking.show_more
    serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted
    Travel Nurse RN - PCU - Progressive Care Unit

    Travel Nurse RN - PCU - Progressive Care Unit

    Nationwide Therapy Group • Mount Clemens, MI, US
    serp_jobs.job_card.full_time
    Nationwide Therapy Group is seeking a travel nurse RN PCU - Progressive Care Unit for a travel nursing job in Mount Clemens, Michigan. Job Description & Requirements.F469;‍⚕️ C...serp_jobs.internal_linking.show_more
    serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted
    Travel Nurse RN - Telemetry

    Travel Nurse RN - Telemetry

    AMN Healthcare Nursing • Mount Clemens, MI, US
    serp_jobs.job_card.full_time
    AMN Healthcare Nursing is seeking a travel nurse RN Telemetry for a travel nursing job in MOUNT CLEMENS, Michigan.Job Description & Requirements. Job Description & Requirements.Registered Nu...serp_jobs.internal_linking.show_more
    serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted
    Travel Long Term Acute Care (RN)

    Travel Long Term Acute Care (RN)

    Triage Staffing • Mount Clemens, MI, US
    serp_jobs.job_card.full_time
    Triage Staffing is seeking a travel nurse RN Long Term Acute Care for a travel nursing job in Mount Clemens, Michigan.Job Description & Requirements. Travel Nursing : Intensive Care Unit Mount Cl...serp_jobs.internal_linking.show_more
    serp_jobs.last_updated.last_updated_variable_hours • serp_jobs.job_card.promoted • serp_jobs.job_card.new
    Travel Nurse RN - Intensive Care Unit (ICU) / Critical Care - $1,808 to $2,008 per week in Petoskey, MI

    Travel Nurse RN - Intensive Care Unit (ICU) / Critical Care - $1,808 to $2,008 per week in Petoskey, MI

    TravelNurseSource • Warren, Michigan, US
    serp_jobs.job_card.full_time
    TravelNurseSource is working with Titan Medical Group to find a qualified ICU / Critical Care RN in Petoskey, Michigan, 49770!. Titan Medical is looking for travelers to fill a Travel ICU position for...serp_jobs.internal_linking.show_more
    serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted
    Travel Nurse RN - OR - Operating Room

    Travel Nurse RN - OR - Operating Room

    LanceSoft • Mount Clemens, MI, US
    serp_jobs.job_card.permanent
    LanceSoft is seeking a travel nurse RN OR - Operating Room for a travel nursing job in Mount Clemens, Michigan.Job Description & Requirements. Years of experience - Required.Proficient in e...serp_jobs.internal_linking.show_more
    serp_jobs.last_updated.last_updated_variable_days • serp_jobs.job_card.promoted
    Travel Nurse RN - Case Management

    Travel Nurse RN - Case Management

    Uniti Med • Detroit, MI, US
    serp_jobs.job_card.full_time
    Uniti Med is seeking a travel nurse RN Case Management for a travel nursing job in Detroit, Michigan.Job Description & Requirements. Days 8a-4 : 30p, rotating weekends.Required Skills & Experi...serp_jobs.internal_linking.show_more
    serp_jobs.last_updated.last_updated_variable_hours • serp_jobs.job_card.promoted • serp_jobs.job_card.new
    Travel Nurse RN - Case Management

    Travel Nurse RN - Case Management

    GHR Healthcare - PH Division • Detroit, MI, US
    serp_jobs.job_card.permanent
    GHR Healthcare - PH Division is seeking a travel nurse RN Case Management for a travel nursing job in Detroit, Michigan.Job Description & Requirements. Travel Case Management RN – Inpatien...serp_jobs.internal_linking.show_more
    serp_jobs.last_updated.last_updated_variable_days • serp_jobs.job_card.promoted
    MDS Nurse

    MDS Nurse

    Ciena Healthcare Management, Inc. • Detroit, MI, United States
    serp_jobs.job_card.full_time
    Are you an experienced nurse who wants to remain clinically involved in patient care without being a bedside nurse? Are you organized, efficient, and able to manage your own work with autonomy? MDS...serp_jobs.internal_linking.show_more
    serp_jobs.last_updated.last_updated_variable_days • serp_jobs.job_card.promoted
    Remote Utility Management Nurses (Insurance Coding & Revenue Management) - AI Trainer ($45-$75 per hour)

    Remote Utility Management Nurses (Insurance Coding & Revenue Management) - AI Trainer ($45-$75 per hour)

    Mercor • Royal Oak, Michigan, US
    serp_jobs.filters.remote
    serp_jobs.job_card.part_time
    Role Overview • • We’re seeking experienced • •Utility Management Nurses • • to support a client’s healthcare product development by leveraging expertise in • •insurance coding and hospital revenue manag...serp_jobs.internal_linking.show_more
    serp_jobs.last_updated.last_updated_variable_days • serp_jobs.job_card.promoted
    Travel Labor & Delivery Registered Nurse

    Travel Labor & Delivery Registered Nurse

    Core Staffing • Rochester, MI, US
    serp_jobs.job_card.full_time
    Core Staffing is seeking a travel nurse RN Labor and Delivery for a travel nursing job in Rochester, Michigan.Job Description & Requirements. Provides leadership in the coordination and delivery...serp_jobs.internal_linking.show_more
    serp_jobs.last_updated.last_updated_variable_days • serp_jobs.job_card.promoted
    Travel Nurse RN - PCU - Progressive Care Unit

    Travel Nurse RN - PCU - Progressive Care Unit

    Fusion Medical Staffing-Nursing • Mount Clemens, MI, US
    serp_jobs.job_card.full_time
    Fusion Medical Staffing-Nursing is seeking a travel nurse RN PCU - Progressive Care Unit for a travel nursing job in Mount Clemens, Michigan. Job Description & Requirements.Facility in Mount Cle...serp_jobs.internal_linking.show_more
    serp_jobs.last_updated.last_updated_variable_hours • serp_jobs.job_card.promoted • serp_jobs.job_card.new
    Travel Nurse RN - Case Management - $2,342 per week

    Travel Nurse RN - Case Management - $2,342 per week

    Care Career • Detroit, MI, United States
    serp_jobs.job_card.full_time
    Care Career is seeking a travel nurse RN Case Management for a travel nursing job in Detroit, Michigan.Job Description & Requirements. Case managers work to facilitate patient care by assessing pati...serp_jobs.internal_linking.show_more
    serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted
    Travel Nurse RN - Case Management - $2,260 per week

    Travel Nurse RN - Case Management - $2,260 per week

    Trustaff • Detroit, MI, United States
    serp_jobs.job_card.full_time
    Trustaff is seeking a travel nurse RN Case Management for a travel nursing job in Detroit, Michigan.Job Description & Requirements. As a Case Management RN, you'll develop, implement, and evaluate i...serp_jobs.internal_linking.show_more
    serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted
    Travel Nurse RN - Telemetry

    Travel Nurse RN - Telemetry

    E-SolHealth • Mount Clemens, MI, US
    serp_jobs.job_card.full_time
    E-SolHealth is seeking a travel nurse RN Telemetry for a travel nursing job in Mount Clemens, Michigan.Job Description & Requirements. Completion of 1 travel assignment.EsolHealth is one of the ...serp_jobs.internal_linking.show_more
    serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted