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)
An exciting opportunity has become available in South Eastern Montana for an experienced Risk Management Director!
This Community Care Center, situated in "The Treasure State," is a hub of constructive health care, ready to provide quality care to all those who walk through its doors. With 40 acute care beds, a 24/7 emergency unit, and full medical and surgical services, they are committed to offering comprehensive care that goes above and beyond. Their attached 30-bed skilled Extended Care facility is a testament to their dedication and expertise in the field of health care.
The Director of Risk Management is the primary person responsible for overseeing compliance activities within the organization. Their duties include managing a variety of risk management activities, such as facility insurance programs, handling claims against the facility, liaising with legal counsel for defense purposes, and administering the risk management program on a daily basis.
The Risk Management Director has multiple responsibilities including managing and analyzing risk management data, conducting risk management education programs, and complying with risk management-related accrediting and regulatory agencies, with the objective of enhancing patient safety, promoting quality care, and minimizing loss to protect the assets of the facility.
Montana is a place of rugged natural beauty, diverse wildlife, and a rich cultural heritage. Montana naturally encourages exploration of the outdoors and has some of the most enjoyable scenic views in the entire country. For families, young adults, and retirees considering moving to the state, Montana has a variety of options to explore, from tiny communities to small cities to robust college towns.
A Bachelor's degree in a health care related field and previous clinical health care experience will surely make any candidate stand out!