Utilization Management Manager

About IntusCare:
IntusCare is the only end-to-end ecosystem built specifically to help Programs of All-Inclusive Care for the Elderly (PACE) programs deliver exceptional care, strengthen financial performance, and stay compliant. IntusCare replaces outdated technology and manual workarounds with purpose-built solutions for care coordination, risk adjustment, population health, and utilization management. We empower teams to take control of their operations and improve outcomes for dual-eligible seniors- some of the most socially vulnerable and clinically complex individuals in the US healthcare system.

Position Overview:

The Utilization Management (UM) Manager is fully accountable for the performance of the UM nurse team supporting a Program of All-Inclusive Care for the Elderly (PACE). This role owns end-to-end delivery of the UM program, including meeting all service-level agreements (SLAs), ensuring consistent application of policies, procedures, and clinical decision support criteria, and driving continuous improvement across the UM function.

The UM Manager spends approximately 25% of their time working directly on UM cases and provider disputes—maintaining clinical currency, modeling best practices, and handling escalated or complex reviews—and the remaining 75% managing team performance, service quality, staffing, coaching, and cros