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 2020 Salary.com)

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Interim Manager, Care Management - Oakland
  • B.E. Smith
  • Oakland, CA
  • Responsible for the day to day operations of facility wide utilization, discharge planning and care ... Build relationships, mentor staff and report progress/shortcomings to Director. * RN with case ...
  • 3 hours ago

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Utilization Review Registered Nurse / RN
  • The CSI Companies
  • Las Vegas, NV
  • Weekly rounds with the Medical Director to discuss current status and discharge planning for ... Must have experience in Managed Care organizations and/or with the Medicare eligible population
  • yesterday

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RN Clinical Manager of Home Health $5,000 Sign On Bonus
  • Brookdale Senior Living
  • Placentia, CA
  • Supervises ongoing case management of all patients ensuring an accurate evaluation and treatment ... Maintains effective and efficient ongoing communication with the Director of Clinical Services (DCS ...
  • 2 days ago

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UTILIZATION MANAGEMENT NURSE SPECIALIST - Relocate to New Mexico
  • Presbyterian Healthcare Services
  • San Jose, CA
  • ... the utilization/benefit management program. Performs care review both prospectively and ... Consults with PHP medical directors and refers for medical director decisions on cases not meeting ...
  • 4 days ago

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Medical Director
  • Wellpath
  • Wheelwright, KY
  • Notifies Regional or Corporate Medical Director and Health Services Administrator or designee of ... control, utilization management, pharmacy and therapeutics and assists in development of ...
  • 4 days ago

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Registered Nurse Case Manager - RN CM
  • CareerStaff Unlimited
  • Kirkland, WA
  • Weekly & Daily Pay with Direct Deposit * Medical, Dental and Vision Insurance * Referral Bonuses ... Assure payments of hospital-based services meet patient-related utilization of management criteria
  • 6 days ago

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Director, Workforce Management
  • RH
  • Corte Madera, CA
  • ... utilization of resources. ‚óŹ Develop contingency plans, direct activities during problem ... manager, assist in the career growth and development of the Workforce Management team by driving ...
  • 6 days ago

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Implementation Manager/Director
  • TekPartners
  • Orlando, FL
  • Skillset Experience OUTCOMES Achieve a monthly team utilization goal of 70 Contribute to team ... Management Skills. The desired candidate should have demonstrated in past work to create scale in ...
  • 6 days ago

Income Estimation for Utilization Management Director jobs
$113,831 to $153,923

Career Path for Utilization Management Director