Utilization Management Supervisor (Hybrid)

CareFirst

📍 Baltimore, MD, United States

Full-time other-general Posted June 21, 2026

Job Description

**Resp & Qualifications**

**PURPOSE:**
Supervises the daily operations of the utilization management (UM) department functions to ensure appropriate coordination of health care services and compliance with UR policies/procedures, as well as regulatory and CareFirst's accreditation standards. We are looking for an experienced clinical leader in the greater Baltimore metropolitan area who is willing and able to work in a hybrid model. The incumbent will be expected to work a portion of their week from home and a portion of their week at a CareFirst location based on business needs and work activities/deliverables that week. The ideal candidate will have previous experience overseeing pre-authorization and UM functions in a payor organization.

**ESSENTIAL FUNCTIONS:**

+ Supervise the daily operations of the UM staff. Recruits, retains and develops a high performing team. Evaluates performance of each team member, generates development plans and sets goals wit...