Utilization Management Director jobs in Lansing, MI

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)

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24-1114 Utilization Specialist - QCSRR Utilization Management
  • CMHA Candidate Experience Site
  • Lansing, MI FULL_TIME
  • CMHA-CEI is a Michigan Certified Bronze Level Veteran Friendly Employer and we encourage active military service member, veterans, and their family member to apply.

    Responsibilities: Under the general administrative supervision of the Quality Improvement and Utilization Management Coordinator, responsible for maintaining the regulatory quality improvement initiatives for Community Mental Health Authority of Clinton-Eaton-Ingham Counties (CMHA-CEI), facilitating utilization of staff and program resources through performance of utilization review and coordination of care functions. Retrieves and analyzes data from a number of sources and provides guidance, training, and consultation to CMHA-CEI staff in the use, interpretation, and critical analysis of data; is responsible for working cooperatively with clinical staff, program management staff, finance and quality improvement components. Responsible for carrying out all activities of the office in such a manner that fulfills CMHA-CEI’s mission, policies, and procedures.

    Requirements: Possession of a Bachelor's or Master's degree in Social Work, Psychology, or related field from an accredited college or university is required. Must have at least three (3) years of work experience in human services; preferably working within utilization or quality improvement areas. Two (2) years’ experience as a practicing Mental Health Professional with experience in reviewing clinical practice against criteria required. Must be able to exercise independent judgment and confidentiality. Ability to communicate accurately and effectively both in writing and verbally is required. Must have proven abilities in problem-solving. Knowledge of multiple regulations, standards, policies, and requirements pertaining to clinical documentation, coding, and billing required. Must have ability to accurately interpret and implement regulatory standards and legal requirements. Possession of a valid Michigan Driver's License and access to reliable means of transportation for job related use is required.

    Conditional Employment Requirements: Employment offers for this position will be contingent upon the results of a background verification and credentialing procedure consisting of: Michigan State Police clearance check, verification of an acceptable driving record, educational background check, and verification of an acceptable work history. Must pass a pre-employment drug screen. 

    To Apply: Applicants must submit an employment application.  Resumes cannot be substituted for the employment application.  CMHA-CEI’s promotion of diversity is fueled by the desire to seek equality of opportunity for all persons. CMHA-CEI is an Equal Opportunity Employer and a Drug Free Workplace.

    Salary/Hours: Starting salary $23.87 - $27.77 per hour, 40 hours per week. Must be able to work some evening hours.

    Location: Quality, Customer Service, and Recipient Rights, Lansing, MI.

  • 1 Month Ago

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Director, Asset Liability Management
  • Jackson National Life Insurance
  • Lansing, MI FULL_TIME
  • If you are an internal associate, please login to Workday and apply through Jobs Hub. Job Purpose This Director, ALM assists in the monitoring and risk management of Jackson's asset/liability position...
  • 11 Days Ago

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Director of Project Management
  • BS&A
  • Lansing, MI FULL_TIME
  • Director of Project Management[In-person or Remote]We are looking for an experienced Director of Project Management that can lead our rapidlygrowing team of Project Managers and Sr Project Managers wi...
  • 1 Month Ago

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Maintenance Director
  • Ciena Healthcare Management
  • Perrinton, MI FULL_TIME
  • Are you an experienced maintenance director? As our Maintenance Director, you will act as a hands-on leader in maintaining the physical plant in our skilled nursing facility. Why just work, when you c...
  • 16 Days Ago

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Director of Nursing
  • Ciena Healthcare Management
  • Perrinton, MI FULL_TIME
  • Are you looking for a nursing leadership opportunity with a growing organization? The Laurels of Fulton has an exceptional opportunity for a Director of Nursing (DON) to join our team. As the Director...
  • 1 Month Ago

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Utilization Manager
  • Brightwell Behavioral Health
  • East Lansing, MI FULL_TIME
  • Utilization Manager Implement, coordinate and participate in a variety of admissions, utilization management, and ongoing review of clinical documentation in acute behavioral health setting. Determine...
  • 13 Days Ago

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0 Utilization Management Director jobs found in Lansing, MI area

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Medical Care Coordinator I
  • Hope Network Neuro Rehabilitation
  • East Lansing, MI
  • The Medical Care Coordinator I is a key associate at Hope Network whose primary responsibilities include: Facilitates th...
  • 3/28/2024 12:00:00 AM

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Registered Nurse - $10k sign on! (external candidates only)
  • Memorial Healthcare
  • Owosso, MI
  • JOB SUMMARY # Works under the supervision of the unit Supervisor/Manager/Director. A registered professional nurse is re...
  • 3/28/2024 12:00:00 AM

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Registered Nurse
  • Memorial Healthcare
  • Owosso, MI
  • $10k Sign on Bonus offered external#applicants!! # JOB SUMMARY # Works under the supervision of the unit Supervisor/Mana...
  • 3/28/2024 12:00:00 AM

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DIGITAL MARKETING CONSULTANT - WILX
  • Gray Television
  • Lansing, MI
  • About Gray Television: Gray Television is a leading media company that owns and operates high-quality stations in 113 te...
  • 3/28/2024 12:00:00 AM

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Operations Administrative Assistant
  • Capital Area Transportation Authority
  • Lansing, MI
  • Job Description Job Description Job Summary - Essential Functions: The Operations Administrative Assistant provides dire...
  • 3/26/2024 12:00:00 AM

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Director Client Strategy
  • King Media
  • East Lansing, MI
  • Growing Michigan-based agency seeks a Director of Client Strategy to add value to our vibrant team. If you are passionat...
  • 3/26/2024 12:00:00 AM

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Director, Digital Distribution and Program Management
  • The Doctors Company
  • East Lansing, MI
  • The Doctors Company Business Development team has an opportunity for an a Director of Digital Distribution and Program M...
  • 3/26/2024 12:00:00 AM

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Solutions Director- Northeast Remote
  • CBRE
  • Lansing, MI
  • Solutions Director- Northeast Remote Job ID 147965 Posted 11-Mar-2024 Service line GWS Segment Role type Full-time Areas...
  • 3/24/2024 12:00:00 AM

Lansing /ˈlænsɪŋ/ is the capital of the U.S. state of Michigan. It is mostly in Ingham County, although portions of the city extend west into Eaton County and north into Clinton County. The 2010 Census placed the city's population at 114,297, making it the fifth largest city in Michigan. The population of its Metropolitan Statistical Area (MSA) was 464,036, while the even larger Combined Statistical Area (CSA) population, which includes Shiawassee County, was 534,684. It was named the new state capital of Michigan in 1847, ten years after Michigan became a state. The Lansing metropolitan area,...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Utilization Management Director jobs
$122,249 to $165,302
Lansing, Michigan area prices
were up 1.3% from a year ago

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