Utilization Management Director jobs in Anderson, SC
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 2024 Salary.com)
Recently Added Utilization Management Director jobs
Director II, Contract Management
- Fluor Corp
-
GREENVILLE, SC
FULL_TIME
- This position provides oversight for all contract management activities on mega projects or key, strategic projects. This role assures, through assigned contract administrators, compliance with Prime Contract, and Fluor Contract Management Practices. The position requires the Contract Director to report to project, department and company senior leadership on the health of the assigned project(s); develop and approve contracting strategies, sourcing, negotiation, award, execution, Contract management administration and close out of various types of contracts, reviewing and approving contract awards within their delegated authority, including Prime Contracts Administration that support services performed on a global project basis. Work is performed in the home office and field locations for projects ranging in duration from short term to long term. • Oversee and manage Contract Management process on the project from Pre-Award, Post-Award through Close-Out in accordance with the Project Execution Plan (PEP) and Project Procedures Manual (PPM), including claims and back charges • Support preparation of bid evaluation plans for large engineering, procurement, and construction (EPC) projects and fabrication Request for Proposal (RFP) packages and participate in both technical and commercial bid evaluation • Bear ultimate responsibility for the quality of the Project RFP packages and Contract documents • Manage interfaces with Project Management, Construction, Project Controls, Quality, Safety, Finance, Client and Joint Venture Partners • Assist Project and Engineering Managers with preparing scope, schedule, and other technical documents for the RFP process • Other duties as assigned• Accredited four (4) year degree or global equivalent in applicable field of study and eighteen (18) years of work-related experience or a combination of education and directly related experience equal to twenty-two (22) years if non-degreed; some locations may have additional or different qualifications in order to comply with local requirements • Ability to communicate effectively with audiences that include but are not limited to management, coworkers, clients, vendors, contractors, and other stakeholders • Job related technical knowledge necessary to complete the job • Ability to learn and apply knowledge of applicable local, state/province, and federal/national statutes and guidelines • Ability to attend to detail and work in a time-conscious and time-effective manner• Accredited degree or global equivalent in Business, Construction Management, or Law • Advanced degree such as an Masters in Business Administration, Masters in Industrial Engineering, Law degree (Juris Doctor), or global equivalent • Experience in Supply Chain for the Semiconductor Industry • Experience in Supply Chain for the Data Center Industry • Eighteen (18) years of overall contract management experience and at least ten (10) years of contract management experience with Fluor, contract administration, and supply chain management experience supporting mega- engineering, procurement, fabrication, and construction/construction management (EPFC/CM) projects/programs • At least ten (10) years of field and international experience • Strong knowledge of Pre-Award process and contracts packages formation • Experience developing negotiating contract terms and conditions specifically for contracts, construction, modularization/fabrication, professional services on a Lump Sum, Unit Price, and cost reimbursable basis • Strong understanding of contracting principles and legal terms and conditions • Strong understanding of the construction industry and contract language associated with EPFC/CM • Experience with development, administration, and management of the multi-million US dollar (or global equivalent) requests for proposal and contracts on mega industrial construction projects • Experience in accurately formulating multiple compensation structures including, but not limited to, reimbursable cost, lump sum, and unit price • Experience in work change and claims evaluation and negotiation • Experience in creating Request for Proposal (RFP)/Contract packages and interfacing with multiple disciplines in their creation • Experience in creating Project Specific Contract Terms and Conditions by flowing down terms from the Prime Contract • Experience working with Project Management, Engineering, and Construction to develop a sound Project Execution Plan and Contract Plan • Experience in the Team Contract Management approach to contracting which includes each department being responsible for a portion of the RFP/Contracting process • Experience in formulating strategies for individual contracts • Experience managing twenty plus (20 ) Contract Management personnel • Strong working knowledge of Contract or Construction Law • Strong knowledge of engineering, procurement, fabrication, and construction/construction management (EPFC/CM) project execution • Knowledge of Contract Management software • Experience with government contracts • Demonstrated strong collaborative and leadership skills • Ability and desire to develop, mentor, and coach employees • Excellent oral and written communication skills • Attention to detail • Self-motivated • Excellent negotiating, interpersonal, and communication skills • Excellent computer and software skills, including Word, Excel, Power Point, Lotus Notes, or Outlook• Maintain a working knowledge of Fluor’s Contract Management Standards, programs and goals by planning and applying Contract Management (CM) practices as established by Fluor on a project site or in an office by the function • Provide consultative functional technical and analytical support in the area of Contract Management for the project management, project controls, and construction management processes and senior leadership as required • Assure compliance with Fluor’s Contract Management Practices as well as Fluor’s Contract Management System (CMSism), or similar system • Manage and actively contribute to improvement of functional work processes and reference systems • Provide assistance in Prime Contract Administration as required • Develop waivers for Bonding policies • Travel to site, as required, to oversee contract management operations
- 1 Month Ago
Director II, Material Management
- Fluor Corp
-
GREENVILLE, SC
FULL_TIME
- The purpose of this position is to apply extensive and diversified knowledge of material management practices and principles to ensure the accurate, timely, and cost-effective identification, sourcing...
- 1 Month Ago
Director I, Material Management
- Fluor Corp
-
GREENVILLE, SC
FULL_TIME
- This position serves as member in the formulation of plans and the execution of the overall material management activity and assists in the planning and execution of specialized material management fu...
- 1 Month Ago
Director of Construction and Risk Management
- Lima One Capital
-
Greenville, SC
FULL_TIME
- DescriptionJob Summary:Join Lima One as the Director of Construction & Risk Management, a pivotal role in advancing our construction lending program to new heights. This leadership position encompasse...
- 1 Month Ago
Director I, Contract Management
- Fluor Corp
-
GREENVILLE, SC
FULL_TIME
- This position provides oversight for all contract management activities on large projects or key, strategic projects. This role assures, through assigned contract administrators, compliance with Prime...
- 1 Month Ago
Director of Risk Management
- UHS
-
GREER, SC
FULL_TIME
- Responsibilities The Carolina Center for Behavioral Health is currently looking for a Director of Risk Management. Who We AreThe Carolina Center for Behavioral Health is a 156-bed private behavioral h...
- 1 Month Ago
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0 Utilization Management Director jobs found in Anderson, SC area
Condition Assessment Leader - Pipeline Assessment & Renewal - Specialized Solutions (US Hybrid)
- Black & Veatch
-
Greenville, SC
- **Condition Assessment Leader - Pipeline Assessment & Renewal - Specialized Solutions (US Hybrid)** Date: Mar 20, 2024 L...
- 4/18/2024 12:00:00 AM
Graphic Designer
- Tigertown Graphics
-
Clemson, SC
- Tigertown Graphics Graphic Artist Tigertown Graphics has been designing and printing t-shirts in downtown Clemson since ...
- 4/18/2024 12:00:00 AM
CAM PSR I
- Scan source
-
Greenville, SC
- Summary: The CAM Partner Support Representative (PSR) is responsible for the entry and management of orders and quotes a...
- 4/18/2024 12:00:00 AM
Pharmaceutical Quality Director
- HTI
-
Greenville, SC
- HTI has an immediate opening for an experienced Pharmaceutical Quality Technical Director for a large pharma manufacture...
- 4/18/2024 12:00:00 AM
Project Manager
- Fun Spot Manufacturing LLC
-
Hartwell, GA
- The Company Fun Spot Manufacturing specializes in the design, construction and maintenance of trampoline parks, embodyin...
- 4/18/2024 12:00:00 AM
General Manager
- Paragon Hotel Company
-
Anderson, SC
- Description: Why you should work for us.... Paid Time Off Choose 6 Holidays Per Year Team Member Room Discounts Referral...
- 4/17/2024 12:00:00 AM
Director of Millwork
- Forge Search
-
Piedmont, SC
- One of our clients, a custom Cabinetry and Millwork Company, is seeking a Director of Millwork. They are experiencing ex...
- 4/16/2024 12:00:00 AM
Graphic Designer
- Tigertown Graphics
-
Clemson, SC
- Tigertown Graphics Graphic Artist Tigertown Graphics has been designing and printing t-shirts in downtown Clemson since ...
- 4/14/2024 12:00:00 AM
About Anderson, South Carolina
Anderson is a city in and the county seat of Anderson County, South Carolina, United States. The population was 26,686 at the 2010 census, and the city was the center of an urbanized area of 75,702. It is one of the principal cities in the Greenville-Anderson--Mauldin Metropolitan Statistical Area, which had a population of 824,112 at the 2010 census. It is further included in the larger Greenville-Spartanburg-Anderson, South Carolina Combined Statistical Area, with a total population of 1,266,995, at the 2010 census. Anderson is just off Interstate 85 and is 120 miles (190 km) from Atlanta an...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Utilization Management Director jobs
$116,818 to $157,961
Anderson, South Carolina area prices
were up 1.5% from a year ago
were up 1.5% from a year ago
What does a Utilization Management Director do?
Utilization Management Director in Johnstown, PA
Prior authorization decisions are also made using Medical Management and Behavioral Health Care Management internally derived policies and procedures developed using evidence-based guidelines based on national, state and locally established standards of practice.
March 01, 2020
Utilization Management Director in Carson City, NV
The utilization management coordinator must have strong project management skills to implement various programs within the allocated budget and set time limits.
January 31, 2020
Utilization Management Director in Melbourne, FL
Develops and administers polices and procedures for utilization control of inpatient and outside referral services countywide and for in a variety of categorical programs including the Medically Indigent Adult (MIA) Program.
January 08, 2020