Post-Acute UM Supervisor

Role Overview

The Post‑Acute UM Supervisor will oversee utilization management activities across post‑acute settings (SNF, ARU, LTACH), including audits, quality reviews, and clinical oversight. The role partners with medical leadership to implement education, workflow refinements, and policy updates aligned with Inter Qual, CMS guidelines, and internal clinical criteria. The supervisor collaborates 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.

The position is fast‑paced, high‑change and requires strong operational leadership, adaptability, and the ability to manage multiple priorities while guiding a team through ongoing transformation.

• 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 Inter Qual 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.

• 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 Inter Qual criteria and/or other evidence‑based medical necessity guidelines.
• Understanding of CMS regulations and Medicare Advantage requirements.

• Certification or formal training in Inter Qual.
• 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 range: $95,000–$120,000 per year.

Benefits include employer‑sponsored health, dental and vision plans with low or no premium; generous paid time off; $100 monthly mobile or internet stipend; stock option program; bonus eligibility for all roles excluding Director and above; commission eligibility for Sales roles; parental leave program; 401(k) program.

Devoted Health is an equal‑opportunity employer 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, respect all employees’ skills, experience, and unique perspectives, and comply with all applicable laws prohibiting discrimination.