Sr Manager Clinical UM Operations - Hybrid NY

Description and Requirements

The Senior Manager, Clinical Utilization Management (UM) Operations is responsible for the strategic and operational leadership oversight of all utilization management activities, ensuring effective, compliant, and high-quality service delivery. This role oversees a team of people leaders who manage clinicians and coordinators responsible for medical necessity review, service authorization, care coordination activities, and other related UM functions. The Senior Manager ensures compliance with all state and federal regulations, contractual obligations, and organizational policies while driving operational excellence, clinical quality, and member-centered outcomes.

Duties//Responsibilities:

• Provide strategic oversight and operational management for all utilization management functions, including prior authorization, concurrent review, and service requests

• Greater New York City Area (NY, NJ, CT residents): $119,900 - $183,430
• All Other Locations (within approved locations): $102,600 - $156,655
  As a candidate for this position, your salary and related elements of compensation will be contingent upon your work experience, education, licenses and certifications, and any other factors Healthfirst deems pertinent to the hiring decision.
  
  In addition to your salary, Healthfirst offers employees a full range of benefits such as, medical, dental and vision coverage, incentive and recognition programs, life insurance, and 401k contributions (all benefits are subject to eligibility requirements). Healthfirst believes in providing a competitive compensation and benefits package wherever its employees work and live.
  
  The hiring range is defined as the lowest and highest salaries that Healthfirst in "good faith" would pay to a new hire, or for a job promotion, or transfer into this role.
  
  WE ARE AN EQUAL OPPORTUNITY EMPLOYER. HF Management Services, LLC complies with all applicable laws and regulations. Applicants and employees are considered for positions and are evaluated without regard to race, color, creed, religion, sex, national origin, sexual orientation, pregnancy, age, disability, genetic information, domestic violence victim status, gender and/or gender identity or expression, military status, veteran status, citizenship or immigration status, height and weight, familial status, marital status, or unemployment status, as well as any other legally protected basis. HF Management Services, LLC shall not discriminate against any disabled employee or applicant in regard to any position for which the employee or applicant is otherwise qualified.
  
  If you have a disability under the Americans with Disability Act or a similar law and want a reasonable accommodation to assist with your job search or application for employment, please contact us by sending an email to careers@Healthfirst.org or calling 212-519-1798 . In your email please include a description of the accommodation you are requesting and a description of the position for which you are applying. Only reasonable accommodation requests related to applying for a position within HF Management Services, LLC will be reviewed at the e-mail address and phone number supplied. Thank you for considering a career with HF Management Services, LLC.
  
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