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)
Description
The Utilization Management Specialist will provide general management over entire service area. This position will serve as liaison between the Utilization Department and State Director, Therapists, and Program/Case Managers and will work closely with the Service Coordinators in order to ensure continuity of care and quality of service to consumers. The UM will have excellent communication and documentation skills and possess an understanding of all mental health and development services. This position plays an active part in the interdisciplinary team.
Requirements
Responsibilities:
What you get:
Competitive Wages
Health Benefits
Paid Time Off
Employee Assistance Plan (dependents eligible)