Director of Utilization Management & Care Optimization

Wellpath; Lemoyne (Cumberland County); On-site; USD 199,992 - 249,995; Full time

Benefits offered by this job

Comprehensive benefits including medical, dental, and vision

DailyPay – receive your money as you earn it

Tuition Assistance and dependent scholarships

Employee Assistance Program (EAP)

Company-paid life insurance

Tax-free Health Spending Account (HSA)

Wellness program

Preferred banking partnership discounts

Job summary

A healthcare services provider is seeking a Director of Utilization Management to lead the development and execution of utilization review initiatives. This role entails overseeing case management, guiding medical staff to ensure quality patient care, and collaborating with external stakeholders. Candidates must be a licensed Medical Doctor (M.D.) or Osteopathic Doctor (D.O.) and have a year of experience in utilization management. Competitive salary and benefits are available.

Qualifications

• One year of experience in utilization management required.
• Experience in performance and/or quality improvement preferred.

Responsibilities

• Lead and oversee utilization review and case management.
• Ensure the use of nationally recognized criteria for reviews.
• Manage UM staff for performance and development.

Skills

Excellent communication skills

Organizational skills

Performance improvement

Education

Medical Doctor (M.D.) or Osteopathic Doctor (D.O.)

Job description

A healthcare services provider is seeking a Director of Utilization Management to lead the development and execution of utilization review initiatives. This role entails overseeing case management, guiding medical staff to ensure quality patient care, and collaborating with external stakeholders. Candidates must be a licensed Medical Doctor (M.D.) or Osteopathic Doctor (D.O.) and have a year of experience in utilization management. Competitive salary and benefits are available.