Manager, UM Preservice Review – Essential Functions and Responsibilities: Ensure accurate and timely review of all preservice requests for medical necessity using current health plan policies and criteria Manage day-to-day operations of preservice UM functions, including workload distribution, staff development, and SOP maintenance Serve as escalation point for complex or high-priority issues requiring additional research or handling Oversee timekeeping and payroll reporting for direct reports (via ADP) Conduct regular 1:1 meetings focused on productivity, quality, and professional development Lead performance management processes, including mid-year and annual evaluations, goal setting, and corrective action plans as needed Manage onboarding and training for new hires; ensure training materials and SOPs remain current Collaborate with Medical Directors and external reviewers to ensure appropriate application of clinical criteria Support delegation audits and inter-rater reliability (IRR) activities Represent Avalon in client facing clinical or process engagements as required or requested by leadership Perform additional duties as assigned Manager, UM Preservice Review – Minimum Qualifications: 5 years experience performing preservice review 1-2 years direct or indirect people leadership Bachelor’s degree or 10 years equivalent experience Active Unrestricted Multi-State Nursing License – LPN Required/RN Preferred Demonstrated ability to interpret documents Excellent communication skills both verbal and written Ability to navigate and master proprietary software programs and proficient in MS Office; specifically, Outlook, PowerPoint, Word, and Excel Healthcare / payor knowledge and experience, including CMS regulatory understanding Manager, UM Preservice Review – Preferred Qualifications: MBA preferred PM18 PIa05189e18c23-25448-403450455c143e31-5e48-4549-b638-05792d185386 About the Manager, UM Preservice Review Position: The Manager, UM Preservice Review oversees the daily operations of preservice utilization management activities, leading a team of nurse clinicians.