Manager of Utilization Management

Remote, Worldwide

Baystate Health ’s Health New England is seeking a Manager of Utilization Management to lead our Utilization Management Health Services Team and help shape the delivery of high-quality, cost-effective, member-centered care in Springfield, MA.

The Manager of Utilization Management leads a team of registered nurses and clinical support professionals while overseeing utilization management services across Commercial, Medicare, and Medicaid lines of business. In partnership with the Medical Director and key organizational stakeholders, you’ll drive quality improvement initiatives, strengthen operational performance, ensure regulatory compliance, and develop strategies that positively impact member outcomes.

Responsibilities:

Lead and Inspire a Clinical Team

Manage, mentor, and develop registered nurses and non-licensed clinical support staff.

Monitor team performance, establish expectations, and provide coaching, training, and continuing education.

Identify operational challenges and implement corrective action plans and performance improvements.

Promote consistent processes, accountability, and professional development across the department.

Drive Clinical Quality and...