Job Description
**Resp & Qualifications**
**PURPOSE:**
Supervises the daily operations of the utilization management (UM) department functions to ensure appropriate coordination of health care services and compliance with UR policies/procedures, as well as regulatory and CareFirst's accreditation standards. We are looking for an experienced clinical leader in the greater Baltimore metropolitan area who is willing and able to work in a hybrid model. The incumbent will be expected to work a portion of their week from home and a portion of their week at a CareFirst location based on business needs and work activities/deliverables that week. The ideal candidate will have previous experience overseeing pre-authorization and UM functions in a payor organization.
**ESSENTIAL FUNCTIONS:**
+ Supervise the daily operations of the UM staff. Recruits, retains and develops a high performing team. Evaluates performance of each team member, generates development plans and sets goals wit...
**PURPOSE:**
Supervises the daily operations of the utilization management (UM) department functions to ensure appropriate coordination of health care services and compliance with UR policies/procedures, as well as regulatory and CareFirst's accreditation standards. We are looking for an experienced clinical leader in the greater Baltimore metropolitan area who is willing and able to work in a hybrid model. The incumbent will be expected to work a portion of their week from home and a portion of their week at a CareFirst location based on business needs and work activities/deliverables that week. The ideal candidate will have previous experience overseeing pre-authorization and UM functions in a payor organization.
**ESSENTIAL FUNCTIONS:**
+ Supervise the daily operations of the UM staff. Recruits, retains and develops a high performing team. Evaluates performance of each team member, generates development plans and sets goals wit...
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Submit ApplicationJob Details
- Location Baltimore, MD
- Job Type Full-time
- Category other-general
- Posted Date June 29, 2026
- Application Deadline July 04, 2026