Medovent Solutions is a nationally recognized healthcare staffing and consulting firm headquartered in Tampa Bay. We are proud to be named one of the Best Places to Work by the Tampa Bay Business Journal, included in the Fast 50 for fastest-growing companies in Tampa Bay, and honored as part of the prestigious Inc. 5000 list of America’s fastest-growing private companies. We are passionate about supporting healthcare organizations and professionals nationwide with expertise, innovation, and integrity.

Interim Utilization Management Manager

Opportunity Overview

• Location: East Coast; remote and onsite requirements will vary by assignment
• Assignment Type: Interim contract
• Division: Case Management and Utilization Management
• Assignment Length: Varies based on organizational needs

Position Summary

Medovent Solutions is seeking an experienced Interim Utilization Management Manager to provide leadership and operational support to a hospital or health system’s Utilization Management team. This opportunity is ideal for an experienced leader who can quickly step into an established operation, assess current workflows, support staff, and provide hands-on leadership that promotes effective utilization management and regulatory compliance.

The ideal candidate is a proven Utilization Management or Case Management leader who is comfortable working in a fast-paced environment, managing competing priorities, and partnering with physicians, physician advisors, Case Management, clinical leadership, Revenue Cycle, payer representatives, and hospital administration.

Key Responsibilities

• Provide day-to-day leadership and operational oversight for the Utilization Management team.
• Assess current processes, workflows, staffing, productivity, performance, and operational needs.
• Lead, support, and mentor Utilization Management nurses and other members of the Case Management team.
• Oversee medical necessity, level-of-care, admission, continued-stay, authorization, and denial-management processes.
• Ensure utilization reviews are completed accurately, consistently, and within established timeframes.
• Partner with physicians, physician advisors, Case Management, Revenue Cycle, and clinical leadership to address utilization concerns.
• Monitor denials, avoidable days, length of stay, authorization issues, and other key Utilization Management performance indicators.
• Use operational and performance data to identify trends, risks, workflow gaps, and improvement opportunities.
• Assist with staffing, scheduling, workload distribution, and daily operational priorities.
• Evaluate staff productivity and provide coaching, education, and performance support as needed.
• Collaborate with hospital leadership to identify operational barriers and recommend practical improvements.
• Serve as a hands-on resource during periods of staffing shortages, leadership transition, or operational change.
• Support compliance with applicable federal and state regulations, payer requirements, and organizational policies.
• Provide clear updates regarding team performance, operational risks, and improvement initiatives to senior leadership.
• Establish stability, accountability, and effective communication throughout the interim assignment.

Required Qualifications

• Active Registered Nurse license.
• At least five years of Case Management, Utilization Management, or combined relevant experience.
• Previous leadership experience within Utilization Management or Case Management.
• Strong understanding of inpatient utilization management, medical necessity, level-of-care determination, and continued-stay review.
• Experience working with physicians, physician advisors, clinical teams, and hospital leadership.
• Knowledge of authorization, denial-management, length-of-stay, and avoidable-day processes.
• Strong operational assessment, critical-thinking, and problem-solving skills.
• Excellent leadership, communication, collaboration, and conflict-resolution abilities.
• Ability to enter a new environment, assess immediate priorities, and provide effective leadership with minimal transition time.
• Ability to work remotely or onsite based on assignment requirements.

Preferred Qualifications

• Bachelor’s degree in Nursing or a related field.
• Previous manager, supervisor, director, or interim leadership experience in Utilization Management.
• Experience leading experienced clinical professionals in a hospital or health system environment.
• Experience assessing and improving Utilization Management workflows, staffing models, and performance metrics.
• Experience supporting healthcare organizations during staffing shortages, leadership transitions, or operational transformation.

Ideal Interim Leader

The successful candidate will be prepared to immediately provide stability, direction, and hands-on leadership to an existing Utilization Management operation. This individual should be:

• Hands-on and operationally focused.
• Comfortable entering a new environment and quickly identifying priorities.
• Confident leading experienced clinical professionals.
• Data-driven and knowledgeable about Utilization Management performance metrics.
• Skilled at identifying workflow gaps and implementing practical solutions.
• Adaptable, decisive, collaborative, and comfortable managing competing priorities.

Medovent Solutions offers an exceptional benefits package including a comprehensive medical/dental/vision plan, a 401(k) savings plan, paid holidays, and vacation pay.

Medovent Solutions is an Equal Opportunity Employer and does not discriminate in its employment practices on the basis of race, religion, sex, color, national origin, age, disability, citizenship, genetic information, veteran status or military service, or any other characteristic protected by federal or Florida law.