Manager of Utilization Management

Baystate Health is hiring a Manager of Utilization Management. This is a remote job – you can work from home in Sri Lanka for a company abroad.

Job summary

• Post: Manager of Utilization Management
• Employer: Baystate Health
• Where: Remote – open to Worldwide (includes Sri Lanka)
• Job type: Full-time
• Level: Senior
• Salary: USD 108,180 – 147,097 per year
• Apply by: 30 December 2026 (or until the post is filled)

What the job involves

• Lead and Inspire a Clinical Team
• Manage, mentor, and develop registered nurses and non-licensed clinical support staff
• Monitor team performance, establish expectations, and provide coaching, training, and continuing education
• Identify operational challenges and implement corrective action plans and performance improvements
• Promote consistent processes, accountability, and professional development across the department
• Drive Clinical Quality and Operational Excellence
• Oversee utilization management processes across Commercial, Medicare, and Medicaid lines of business
• Partner with the Medical Director to develop Quality Improvement Activities and oversee Delegation Agreements

Working remotely from Sri Lanka

• You need a laptop, a stable internet connection and good written English.
• Check the working hours (time zone) and how you will be paid (for example bank transfer, Payoneer or Wise) before you accept an offer.
• Foreign income received through banks in Sri Lanka may have tax rules – keep your payment records.

Tip from JobPortal

Read the employer's requirements carefully and send a short, clear CV that matches this post. Apply only through the official link and never pay money to get a job.

Source

This listing comes from Himalayas. Read the full original advert and apply there.

• Bachelors Degree in Nursing, required
• Active RN License in Massachusetts, required
• Minimum of 5 years of progressively responsible case management and/or utilization management experience
• Demonstrated leadership and negotiation experience
• Project management experience
• Strong knowledge of state licensure, regulatory requirements, and NCQA accreditation standards
• Knowledge of data collection, analysis, and presentation methods
• Familiarity with Medicare and Medicaid benefits and regulatory requirements