• Report to the Associate Director of Care Management • Use clinical nursing skills to support coordination, documentation, and communication of medical services and benefit administration determinations • Operate within established guidelines and use advanced technical expertise to address moderately complex issues • Determine methods, resources, schedules, and goals based on assigned goals • Responsible for leadership and oversight of the physical health Utilization Management staff in daily operations • Hire, coach, counsel and evaluate performance of direct reports • Implement and maintain processes compliant with MDHHS and NCQA guidelines • Work with UM leadership to reduce inefficiencies and provide solutions to improve clinical outcomes • Collect and analyze data to guide operational metrics and associate performance • Coordinate and communicate with Providers, Members, or other parties to facilitate care and treatment • Facilitate cross-departmental collaboration and conduct briefings and area meetings; maintain frequent contact with other managers across departments.