Director-Utilization Management
Director-Utilization Management
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$ 83200 - 93600
1 Vacancy
Job Description
Direct and manage the daytoday operations of the Utilization Review department. Position is in person in Carlsbad CA. This is a full time exempt position.
ESSENTIAL FUNCTIONS:
- Monitor utilization of services and optimize reimbursement for the facility while maximizing use of the patients provider benefits for their needs.
- Conducts and oversees concurrent and retrospective reviews for all patients.
- Act as a liaison between Medicaid reviewers and the staff completing required paperwork to facilitate the Utilization Review process.
- Collaborates with physicians therapist and nursing staff to provide optimal review based on patient needs.
- Collaborates with ancillary services in order to prevent delays in services.
- Evaluates the UM program for compliance with regulations policies and procedures.
- May review charts and make necessary recommendations to the physicians regarding utilization review and specific managed care issues.
- Provide staff management to including hiring development training performance management and communication to ensure effective and efficient department operation.
Benefits Include:(depending on the number of worked)
- Health insurance
- Paid time off
- Dental insurance
- 401(k)
- Vision insurance
- Flexible schedule
- Life insurance
- 401(k) matching
- Employee discount
- Flexible spending account
- Health savings account
- Parental leave
- Employee assistance program
EDUCATION/EXPERIENCE/SKILL REQUIREMENTS:
- Bachelors Degree in nursing or other clinical field required. Masters Degree in clinical field preferred.
- Six or more years clinical experience with the population of the facility preferred.
- Four or more years experience in utilization management required.
- Three or more years of supervisoryexperience required.
Compensation for roles at Montecatini varies depending on a wide array of factors including but not limited to the specific location role skill set and level of experience.As required by local law Montecatini provides a reasonable hourly range of compensation for roles that may be hired in California as set forth below.
Role Location: California
Calculated Salary Range for role.
California: $83200 to $93600
Required Experience:
Director
Employment Type
Full-Time
