**Duties/Responsibilities:**

+ Oversees utilization management functions which include timely authorizations related to pre-certification, concurrent review, referrals, and other plan services
+ Develops and monitors goals for staff; provides ongoing feedback and coaching; conducts annual performance reviews; leads by example; and ensures an atmosphere of open communication, teamwork, and ownership and empowerment to make informed decisions
+ Collaborates with medical staff and reviews medical charts to obtain additional information required for appropriate utilization management and to solve complex clinical problems
+ Allocate, monitor, and control resources while delegating and monitoring workloads
+ Develops and analyzes operational and analytical reports to monitor and track operational efficiency
+ Properly documents utilization management activities and rationale for all decisions in electronic medical records systems
+ Functions as a clinical resource...