Utilization Management Director jobs in California
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
- Redlands Community Hospital - UTILIZATION MANAGEMENT
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Redlands, CA
FULL_TIME
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Position Details
- Salary: 60.00 - 60.00 Hourly
- Shift: Days, 8-hour shifts
- Status: PRN
The purpose of the Care Manager position is to support the physician and interdisciplinary team in facilitating patient care, with the underlying objective of enhancing the quality of clinical outcomes and patient satisfaction while managing the cost of care and providing timely and accurate information to payers. The role integrates and coordinates utilization management, care facilitation and discharge planning functions. The Care Manager is accountable for a designated patient caseload and plans effectively in order to meet patient needs, manage the length of stay, and promote efficient utilization of resources. In addition, the Care Manager helps drive change by identifying areas where performance improvement as needed (e.g., day to day workflow, education, process improvements, patient satisfaction). This position reports to the Director, Case Management.
QUALIFICATIONS: 1. Current California State License as a Registered Nurse required.
2. Current CPR certification required.
3. BS degree in nursing from an accredited school of nursing preferred.
4. Three or more years strong clinical experience in clinical practice area to which assigned preferred.
5. Case Management (ACM or CCM) certification preferred.
6. Strong analytical, data management, and computer skills desired.7. MAB certification required within 3 months of hire if assigned to the Emergency department or Behavioral Health.
- 2 Months Ago
- KHS
-
Bakersfield, CA
FULL_TIME
- KHS reasonably expects to pay starting compensation for the position of Director of Utilization Management in the range of $153,597 - $199,676 annually. Our Mission.. Kern Health Systems is dedicated ...
- 8 Days Ago
- Alameda Health Consortium/Community Health Center...
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San Leandro, CA
FULL_TIME
- Organizational Description The Community Health Center Network (CHCN) is a partnership between eight health service organizations in Alameda County, whose mission is to provide a comprehensive range o...
- 12 Days Ago
- Astrana Health
-
Monterey, CA
FULL_TIME
- Job Title: Director, Utilization Management Department: Health Services - UM About the Role: Leads and shapes the Utilization Management (UM) Strategy for Astrana Health while providing management ove...
- 2 Months Ago
- Astrana Health
-
Monterey, CA
FULL_TIME
- Job Title: Director, Utilization Management Department: Health Services - UM About the Role: Leads and shapes the Utilization Management (UM) Strategy for Astrana Health while providing management ove...
- 2 Months Ago
- Kaiser Permanente
-
Moreno Valley, CA
OTHER
- Job Summary: Develops, manages and directs the Utilization Management programs in a Service Area or a Medical Center. Develops and manages programs that emphasize appropriate admissions as well as con...
- 2 Months Ago
Utilization Management Director jobs at Popular Companies
- Asian Pacific Environmental Network
-
Oakland, CA
- The Asian Pacific Environmental Network (APEN) was founded in 1993 to bring together a collective voice among the divers...
- 6/2/2024 12:00:00 AM
- Kaiser Permanente
-
Aurora, CO
- Salary Range: $65.38/hour - $84.56/hour $60.53 - $71.20 Job Summary: Manages the overall, regionwide utilization managem...
- 6/1/2024 12:00:00 AM
- Principal Financial Group
-
Des Moines, IA
- What You'll Do: Were looking for a Risk Management Director to join our Principal Asset Management team. In this role, y...
- 6/1/2024 12:00:00 AM
- MacroGenics, Inc.
-
Rockville, MD
- MacroGenics is a leader in the discovery and development of innovative medicines that utilize our next generation antibo...
- 5/30/2024 12:00:00 AM
- Experis
-
Winston-Salem, NC
- Build your career with Experis, a ManpowerGroup company as we connect human potential to the power of business. Through ...
- 5/30/2024 12:00:00 AM
- NEWMARK
-
Dallas, TX
- Job Description Newmark (NMRK) is one of the world's leading commercial real estate advisory firms. We provide a fully i...
- 5/30/2024 12:00:00 AM
- Oberon Securities, LLC
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New York, NY
- Oberon Securities, based in New York City, is seeking experienced Managing Directors with expertise raising asset, cash ...
- 5/29/2024 12:00:00 AM
- Leadenhall Search & Selection
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- Leadenhall Search & Selection are currently recruiting for Directors and Partners on behalf of a global, fast-growing In...
- 5/29/2024 12:00:00 AM