Utilization Management Director jobs in the United States

Utilization Management Director leads and directs the utilization review staff and function for a healthcare facility. Determines policies and procedures that incorporate best practices and ensure effective utilization reviews. Being a Utilization Management Director manages and monitors both concurrent reviews to ensure that the patient is getting the right care in a timely and cost-effective way and retrospective reviews after treatment has been completed. Provides analysis and reports of significant utilization trends, patterns, and impacts to resources. Additionally, Utilization Management Director consults with physicians and other professionals to develop improved utilization of effective and appropriate services. Requires a master's degree. Typically reports to top management. Typically requires Registered Nurse(RN). The Utilization Management Director manages a departmental sub-function within a broader departmental function. Creates functional strategies and specific objectives for the sub-function and develops budgets/policies/procedures to support the functional infrastructure. Deep knowledge of the managed sub-function and solid knowledge of the overall departmental function. To be a Utilization Management Director typically requires 5+ years of managerial experience. (Copyright 2022 Salary.com)

P
Utilization Management Clinician
  • PacificSource
  • Salem, OR
  • Identify high cost utilization and refer to Large Case Reinsurance RN and Care Management team as appropriate. * Assist Medical Director in developing guidelines and procedures for Health Services ...
  • 2 days ago

I
Director of Utilization Management
  • Ironside Human Resources
  • Branson, MO
  • The Director of Utilization Management Job Description: * Full-time, direct hire opportunity * Mon-Fri, day shift * May require some OT for staffing levels * Competitive pay based on experience
  • 2 days ago

R
Utilization Review Coordinator - PVH
  • Relig Staffing, Inc.
  • Tucson, AZ
  • Alert Nursing and Clinical Services Director of any abnormalities in the UM process. Provide ongoing data entry in the Network Utilization Management MIDAS software System. Provide timely ...
  • 2 days ago

E
UTILIZATION REVIEW RN - **$10,000 SIGN ON BONUS!**
  • Elliot Hospital
  • Manchester, NH
  • ... case manager and still denied by the payer medical director. * Facilitating non-coverage issuance for cases that do not meet admission or continued stay criteria or admission criteria based on ...
  • 3 days ago

B
Registered Nurse RN Associate Director Emergency Department
  • Banner Health
  • Fallon, NV
  • ... care management and resource utilization. 2. Leads change by developing, implementing and ... director. Seeks and utilizes input from staff and oversees change implementation. Ensures ...
  • 4 days ago

T
RN Case Manager PRN
  • Timpanogos Regional Hospital
  • Orem, UT
  • Direct activities to identify and provide for the needs of the under-resourced patient population ... Certification in case management or utilization review preferred. * InterQual experience preferred
  • 4 days ago

P
Endoscopy Nurse Manager (Dekalb)
  • Prestige Staffing Healthcare Jobs - Clinical u0026 Allied Health
  • Decatur, GA
  • Assume responsibility for performance management, consult with Directors as appropriate. Perform ... Demonstrate awareness of cost-effective resource utilization. * Demonstrate enthusiasm, energy ...
  • 5 days ago

D
Utilization Manager-Duke Raleigh
  • Duke Health
  • Raleigh, NC
  • ... utilization management. * Contributes to a positive working environment and performs other duties as assigned/directed to enhance the overall efforts for the organization. * Actively participates in ...
  • 5 days ago

R
Director, Case Management
  • Redlands Community Hospital - UTILIZATION...
  • Redlands, CA FULL_TIME
  • Reporting to the Vice President, Patient Care Services, this position is responsible for the overall direction of the Ca...
  • 1 Month Ago

U
Clinic Services Specialist- Utilization Management
  • Utilization Management - Jobs@UIOWA Careers
  • Iowa City, IA FULL_TIME
  • The Utilization Management Department at the University of Iowa is seeking a Precert Services Specialist to perform bene...
  • 2 Months Ago

R
Director, Case Management
  • Redlands Community Hospital - UTILIZATION...
  • Redlands, CA FULL_TIME
  • Reporting to the Vice President, Patient Care Services, this position is responsible for the overall direction of the Ca...
  • 1 Month Ago

U
Clinic Services Specialist- Utilization Management
  • Utilization Management - Jobs@UIOWA Careers
  • Iowa City, IA FULL_TIME
  • The Utilization Management Department at the University of Iowa is seeking a Precert Services Specialist to perform bene...
  • 2 Months Ago

P
Utilization Management Assistant Director
  • Partners Health Management
  • Kannapolis, NC FULL_TIME
  • Competitive Compensation & Benefits Package! Position eligible for – Annual incentive bonus plan Medical, dental, and vi...
  • 16 Days Ago

P
Utilization Management Assistant Director
  • Partners Health Management
  • Hickory, NC FULL_TIME
  • Competitive Compensation & Benefits Package! Position eligible for – Annual incentive bonus plan Medical, dental, and vi...
  • 17 Days Ago

P
Utilization Management Assistant Director
  • Partners Health Management
  • Elkin, NC FULL_TIME
  • Competitive Compensation & Benefits Package! Position eligible for – Annual incentive bonus plan Medical, dental, and vi...
  • 17 Days Ago

P
Utilization Management Assistant Director
  • Partners Health Management
  • Statesville, NC FULL_TIME
  • Competitive Compensation & Benefits Package! Position eligible for – Annual incentive bonus plan Medical, dental, and vi...
  • 17 Days Ago

Income Estimation for Utilization Management Director jobs
$120,496 to $162,934

Career Path for Utilization Management Director