Utilization Management Director jobs in Evansville, IN
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
Case Management Specialist - Utilization Review
- Utilization Review in Owensboro, KY - Owensboro
-
Owensboro, KY
FULL_TIME
-
Summary
Job Summary
Facilitates cost-effective, quality patient outcomes by determining the appropriate level of care and providing guidance, education, and support to assigned patients.Job Responsibilities- Assessment of complete chart and knowledge of patient's medical condition, financial status, emotional needs, and support systems.
- Conducts initial and concurrent reviews of clinical documentation for medical necessity and appropriate level of care using approved criteria within specified time frame.
- Provides appropriate clinical information to payers as requested within specified time frame.
- Collaborates with the Physician, Medical Director, Director, Manager, and Supervisor of Case Management on patients who are not meeting the regulatory requirements for hospitalization.
- Delivers regulatory letters to patients as needed.
- Provides education and acts as a resource for physicians, staff, and patients/families regarding utilization review processes.
- Trains new case managers, students, and interns as needed.
Qualifications- Associate's degree or higher in Nursing required upon hire AND
- Bachelor's degree or higher in Nursing required within 5 years of employment in this position
- No experience required
- RN - Licensed as a Registered Nurse. Eligible to practice nursing in the State of Kentucky required upon hire
Skills and Attributes- Requires critical thinking skills and decisive judgment.
- Works under minimal supervision.
- Must be able to work in a stressful environment and take appropriate action.
Physical Demands- Standing: Occasionally
- Walking: Occasionally
- Sitting: Frequently
- Lifting 0-25 lbs: Rarely
- Lifting 25-75 lbs: Never
- Lifting over 75 lbs: Never
- Carrying 0-25 lbs: Rarely
- Carrying 25-75 lbs: Never
- Carrying over 75 lbs: Never
- Pushing/Pulling 0-25 lbs: Rarely
- Pushing/Pulling 25-75 lbs: Never
- Pushing/Pulling over 75 lbs: Never
- Climbing: Rarely
- Bending/Stooping: Rarely
- Kneeling: Rarely
- Crouching/Crawling: Rarely
- Reaching: Occasionally
- Talking: Frequently
- Hearing: Occasionally
- Repetitive Foot/Leg Movements: Never
- Repetitive Hand/Arm Movements: Frequently
- Keyboard Data Entry: Frequently
- Running: Never
- Vision: Depth Perception: Frequently
- Vision: Distinguish Color: Frequently
- Vision: Seeing Far: Frequently
- Vision: Seeing Near: Frequently
Owensboro Health Core Commitments
INTEGRITY - We conduct ourselves with a high level of responsibility, reliability and honesty because we take seriously the trust of our patients and coworkers.
RESPECT - We value and accept the unique talents and contributions of every patient, customer and team member in the Owensboro Health community.
TEAMWORK - We build a spirit of connectivity and fellowship by striving together to overcome obstacles, surpass goals, celebrate accomplishments and plan the future.
INNOVATION - We foster original ideas and creative solutions that improve our daily work and promote the mission of Owensboro Health.
SERVICE - We focus on service to patients, customers and team members by anticipating their needs, thoughtfully meeting those needs and continually improving the quality of everything we do.
EXCELLENCE - We reach beyond basic expectations to expand our knowledge and awareness, produce exceptional work and provide outstanding service. - 1 Month Ago
Utilization Management Specialist - Carbondale, IL
- Gateway Foundation, Inc.
-
Carbondale, IL
FULL_TIME
- Utilization Management Specialist - Carbondale, IL Post Date: Mar 20, 2024 Location: Carbondale, IL, US, 62901 Position Type: Full Time Requisition Number: 31696 Work Schedule: Monday - Friday Are you...
- 1 Month Ago
Director of Nursing
- ClearView Healthcare Management
-
Owensboro, KY
FULL_TIME
- Long Term Care Facility is seeking a Director of Nursing! Responsibilities Direct, oversee and evaluate all nursing personnel (registered nurses, LPN etc.) Guide staffing procedures Set objectives and...
- 10 Days Ago
Director Of Nursing
- Infinity Healthcare Management
-
Rockport, IN
FULL_TIME
- NOW HIRING - Director of Nursing (DON)/Registered Nurse (RN) New Wages We are looking for ambitious and energetic talent to join our Team!! The Director of Nursing leads and directs the overall clinic...
- 28 Days Ago
Assistant Director of Nursing
- Infinity Healthcare Management
-
Rockport, IN
FULL_TIME
- WE ARE LOOKING FOR AN ASSISTANT DIRECTOR OF NURSING TO JOIN OUR TEAM! JOB SUMMARY:Support the Director of Nursing in planning, developing, organizing, directing and evaluating services and activities ...
- 9 Days Ago
Director of Quality Risk Management and Compliance
- Brentwood Springs
-
Newburgh, IN
FULL_TIME
- Overview Director of Quality, Compliance, and Risk Brentwood Springs is a 48-bed behavioral hospital located in Newburgh, IN. The hospital offers inpatient and outpatient mental health and addiction t...
- 21 Days Ago
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0 Utilization Management Director jobs found in Evansville, IN area
About Evansville, Indiana
Evansville is a city and the county seat of Vanderburgh County, Indiana, United States. The population was 117,429 at the 2010 census, making it the state's third-most populous city after Indianapolis and Fort Wayne, the largest city in Southern Indiana, and the 232nd-most populous city in the United States. It is the commercial, medical, and cultural hub of Southwestern Indiana and the Illinois-Indiana-Kentucky tri-state area, home to over 911,000 people. The 38th parallel crosses the north side of the city and is marked on Interstate 69.
Situated on an oxbow in the Ohio River, the city is of...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Utilization Management Director jobs
$119,982 to $162,240
Evansville, Indiana area prices
were up 1.3% from a year ago
were up 1.3% 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