Job Description
A bit about this role:
The Post-Acute UM Supervisor will oversee utilization management activities across post-acute settings (SNF, ARU, LTACH), including audits, quality reviews, and clinical oversight. This role will partner with medical leadership to implement education, workflow refinements, and policy updates aligned with InterQual, CMS guidelines, and internal clinical criteria.
The supervisor will also collaborate closely with clinical, operational, and technology teams to design, implement, and optimize AI/LLM-enabled workflows that support prior authorization review, concurrent review, documentation quality, and care transition efficiency. This includes identifying opportunities to reduce administrative burden while improving consistency, accuracy, and turnaround time.
This is a fast-paced, high-change environment requiring strong operational leadership, adaptability, and the ability to manage multiple priorities while guiding a team through ongoing transformation.
Your Responsibilities and Impact will include:
Supervise the Post-Acute UM team, including hiring, scheduling, training, performance management, coaching, and corrective action
Monitor and act on key UM and operational metrics (timeliness, approval/denial trends, readmissions, length of stay, throughput), identifying patterns and driving performance improvement
Support consistent application of InterQual criteria and CMS/Medicare Advantage guidelines across post-acute review decisions
Lead quality audits and ensure documentation integrity and compliance with regulatory and health plan standards
Partner with clinical leadership and IT/analytics teams to implement and enhance AI/LLM-supported workflows (e.g., clinical summarization, decision support, documentation assistance, and queue prioritization)
Drive workflow standardization and identify automation opportunities to improve efficiency and staff experience
Support education and onboarding for new and existing staff on post-acute UM processes and tools
Required skills and experience:
Active unrestricted RN license with a minimum of 4 years of clinical experience
At least 3 years of utilization management experience within a health plan or managed care setting
At least 1–2 years of supervisory or team lead experience
Working understanding of AI/LLM tools and their application in clinical or UM workflows
Knowledge of InterQual criteria and/or other evidence-based medical necessity guidelines
Understanding of CMS regulations and Medicare Advantage requirements
Desired skills and experience:
Certification or formal training in InterQual
Experience working in post-acute care utilization management (SNF, ARU, LTACH)
Experience participating in or leading AI/automation or digital transformation initiatives within UM or care management environments
Salary Ragne: $95,000-$120,000
The pay range listed for this position is the range the organization reasonably and in good faith expects to pay for this position at the time of the posting. Once the interview process begins, your talent partner will provide additional information on the compensation for the role, along with additional information on our total rewards package. The actual base salary offered will depend on a variety of factors, including the qualifications of the individual applicant for the position, years of relevant experience, specific and unique skills, level of education attained, certifications or other professional licenses held, and the location in which the applicant lives and/or from which they will be performing the job.
Our Total Rewards package includes:
Employer sponsored health, dental and vision plan with low or no premium
Generous paid time off
$100 monthly mobile or internet stipend
Stock options for all employees
Bonus eligibility for all roles excluding Director and above; Commission eligibility for Sales roles
Parental leave program
401K program
And more....
*Our total rewards package is for full time employees only. Intern and Contract positions are not eligible.
Healthcare equality is at the center of Devoted’s mission to treat our members like family. We are committed to a diverse and vibrant workforce.
At Devoted Health, we’re on a mission to dramatically improve the health and well-being of older Americans by caring for every person like family. That’s why we’re gathering smart, diverse, and big-hearted people to create a new kind of all-in-one healthcare company — one that combines compassion, health insurance, clinical care, service, and technology-to deliver a complete and integrated healthcare solution that delivers high quality care that everyone would want for someone they love. Founded in 2017, we've grown fast and now serve members across the United States. And we've just started. So join us on this mission!
Devoted is an equal opportunity employer. We are committed to a safe and supportive work environment in which all employees have the opportunity to participate and contribute to the success of the business. We value diversity and collaboration. Individuals are respected for their skills, experience, and unique perspectives. This commitment is embodied in Devoted’s Code of Conduct, our company values and the way we do business.
As an Equal Opportunity Employer, the Company does not discriminate on the basis of race, color, religion, sex, pregnancy status, marital status, national origin, disability, age, sexual orientation, veteran status, genetic information, gender identity, gender expression, or any other factor prohibited by law. Our management team is dedicated to this policy with respect to recruitment, hiring, placement, promotion, transfer, training, compensation, benefits, employee activities and general treatment during employment.
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