UST HealthProof · 13 hours ago
Supervisor, Utilization Management
United States
Full-time
Remote
Mid, Senior Level
$75K/yr - $95K/yr
3+ years expUST HealthProof is a trusted partner for health plans, offering an integrated ecosystem for health plan operations. The Supervisor, Utilization Management is responsible for managing staff who provide operational support and medical review for Medicare Advantage clients, ensuring accurate decisions and developing reporting trends for management.
Hospital & Health Care
Responsibilities
Develop and implement effective strategies that enables the department to maintain efficient and cost-effective processes
Establish and maintain UM Intake processes and systems to ensure data quality to support UST’s quality, production, and financial goals
Drive operational excellence into all processes and departmental interactions
Lead employees and other management in developing effective intercompany workflows for different processes
Lead, coach, develop, and implement training programs to ensure staff competence
Operate a departmental audit/oversight program that focuses on continuous quality improvement
Qualification
Required
Bachelor's degree in Business Administration, Health Care Administration, Marketing, or a related field
Active RN license in state of residence
Three to five years' experience of progressive responsibility in an insurance or managed care environment
One year supervisory or lead experience in insurance or managed care is required
Experience in Utilization Management
Ability/willingness to develop, recommend and execute solutions to ad hoc issues and challenges that may arise
Strong knowledge of clinical and quality improvement processes and concepts
Subject matter expertise in Medicare Advantage and clinical operations management (i.e., Utilization Management, Case Management, etc.)
Must be self-motivated, results-oriented and can work well under pressure
Ability to effectively present information and respond to questions from internal and external contacts at all levels of the organization
Proficient in current industry standard PC applications and systems
Must demonstrate leadership ability and team building skills to effectively supervise professional and non-professional staff and interact with all levels of management
Ability to work with and empower others on a collaborative basis to ensure success of unit team
Ability to effectively exchange information, in verbal or written form, by sharing ideas, reporting facts and other information, responding to questions, and employing active listening techniques
Ability to establish workflows, manage multiple projects, and meet necessary deadlines
Ability to maintain confidentiality
Benefits
Full-time, regular employees accrue up to 16 days of paid vacation per year
Receive 6 days of paid sick leave each year (pro-rated for new hires throughout the year)
10 paid holidays
Eligible for paid bereavement leave
Eligible to participate in the Company’s 401(k) Retirement Plan with employer matching
Eligible for medical, dental, and vision insurance
Basic life insurance
Accidental death and disability insurance
Short- and long-term disability benefits
May purchase additional voluntary short-term disability benefits
Participate in a Health Savings Account (HSA)
Flexible Spending Account (FSA) for healthcare, dependent child care, and/or commuting expenses
Potential for quarterly incentive-based bonuses and or commissions depending on role
Company
UST HealthProof
UST HealthProof offers risk adjustment, quality programs, and healthcare payer technology services. It is a sub-organization of UST.
501-1000 employees
H1B Sponsorship
UST HealthProof has a track record of offering H1B sponsorships. Please note that this does not
guarantee sponsorship for this specific role. Below presents additional info for your
reference. (Data Powered by US Department of Labor)
Distribution of Different Job Fields Receiving Sponsorship
Represents job field similar to this job
Trends of Total Sponsorships
2025 (71)
2024 (43)
2023 (31)
2022 (3)
Funding
Current Stage
Late StageTotal Funding
unknown2025-09-04Acquired
Leadership Team
Kevin Adams
Chief Executive Officer
Beth Maxwell
VP Product Delivery and Partnerships
Recent News
2025-12-06
Precedence Research
2025-11-21
2025-11-07
Company data provided by crunchbase