Nurse Manager, Utilization Management– Physical Health
# Nurse Manager, Utilization Management– Physical Health **Trillium Health Resources** · United States · `Remote` · `Full Time` 💼 **Уровень роли:** `Manager` 💰 **Компенсация:** `$78,624 – $105,158` 🕒 **Статус:** *Опубликовано: сегодня* · *Источник: Himalayas (JSON API)* --- ### Top Skills & Match 🎯 **Ключевой стек роли:** `[Nurse-Manager]` `[Utilization-Management-Nurse]` `[Clinical-Care-Manager]` `[Health-Services-Manager]` `[RN-Manager]` `[Utilization-Management-Manager]` `[Healthcare-Utilization-Manager]` `[Utilization-Management-Supervisor]` --- ### About the Role Pay Plan Title: NurseManager, Utilization Management Working Title: Nurse Manager, Utilization Management – Physical Health Cost Center: 4700/Utilization Management FLSA Status: Exempt Posting Salary Range: $78,624 - $105,158 Office Location: Remote within North Carolina POSTING DETAILS: Make an Impact Trillium Health Resources is a Tailored Plan and Managed Care Organization (MCO) serving 46 counties across North Carolina. We manage services for individuals with serious mental health needs, substance use disorders, traumatic brain injuries, and intellectual/development (IDD) disabilities. Our mission is to help individuals and families build strong foundations for healthy, fulfilling lives. Why Work for Us ? Trillium believes that empowering others begins with supporting our team. We offer our employees: - A collaborative, mission-driven work environment - Competitive benefits and work-from-home options for most positions - Opportunities for professional growth in a diverse inclusive culture Every day, our work changes lives – from children thriving through early intervention and school-based therapies, to adults with severe mental illness living independently and contributing to their communities. If you are looking for a unique opportunity to make a tangible impact on the lives of others, apply today! What We’re Looking For Trillium Health Resources has a career opening for a Nurse Manager, Utilization Management – Physical Health to join our team! The Nurse Manager, Utilization Management – Physical Health leads day-to-day utilization management operations and oversees utilization management teams responsible for authorization and clinical review workflows. The role is accountable for performance monitoring, staff guidance, and manages workflow execution to ensure timely, accurate determinations and consistent application of review standards. On a typical day, you might: - Lead utilization management teams and oversee daily authorization workflows, including intake, review coordination, and determination processing. - Manage staff workload to ensure timely completion of authorization activities. - Monitor turnaround times, decision accuracy, and documentation quality across the team. - Review cases and decisions to ensure consistent application of clinical criteria and policies. - Provide clinical guidance and direction to staff on complex or escalated authorization issues. Resolve provider concerns, complaints, and authorization-related escalations. Employee Benefits: Trillium knows that work/life balance is essential. That’s why we offer: - Typical working hours: 8:30 am – 5:00 pm; flexible work schedules available for some positions with management approval. - Work-from-home options available for most positions - Health Insurance with no premium for employee coverage - Flexible Spending Accounts - 24 days of Paid Time Off (PTO) plus 12 paid holidays in your first year - NC Local Government Retirement Pension (defined-benefit plan) - 401k with 5% employer match and immediate vesting - Public Service Loan Forgiveness (PSLF) qualifying employer - Quarterly stipend for remote work supplies Qualifications Required: - Associate's degree in Nursing and three (3) years of experience as an RN in utilization review, utilization management, or prior authorization, to include experience in clinical acute inpatient care (ER, ICU, Med-Surg), post-acute care, health plan operations, and/or behavioral health; OR - Bachelor's degree in Nursing and one (1) year of experience as an RN in utilization review, utilization management, or prior authorization, to include experience in clinical acute inpatient care (ER, ICU, Med-Surg), post-acute care, health plan operations, and/or behavioral health; OR - Equivalent combination of education and experience. - Active North Carolina Licensure as a Registered Nurse (RN). - Must have a valid driver’s license. - Must reside within North Carolina. - Must be able to travel within catchment as required. Preferred: - Supervisory experience of two (2) or more employees - Previous working experience with Medicaid Experience with InterQual guidelines and/or NC Medicaid Clinical Coverage Policies Deadline for Application: October 12, 2026 at 11:59 PM How to Apply To be considered, submit your application and resume through our ADP Career Center. Your resume must include: - Employer name, dates of service (month/year), average hours worked per week, and essential job duties - Education details (degree type, date awarded, institution, field of study) - Licensure/certification information, if applicable After submission, your resume will be reviewed to ensure it meets the essential criteria for the position. You’ll be notified by HR regarding your application status as appropriate. All applicants will receive a final update once the recruitment cycle closes. Join our Talent Community through ADP to stay informed about future opportunities. Be sure to keep your resume updated in your profile. #Innovation #Technology #Careers #NorthCarolina #BehavioralHealth Originally posted on Himalayas
- Nurse-Manager
- Utilization-Management-Nurse
- Clinical-Care-Manager
- Health-Services-Manager
- RN-Manager
- Utilization-Management-Manager
- Healthcare-Utilization-Manager
- Utilization-Management-Supervisor
Наблюдалась 2026-10-02, впервые 2026-10-02, источник — Himalayas (JSON API).