Director of Utilization Management & Payer Relations

Oceans Healthcare, L.L.C.; Shreveport (LA); On-site; USD 120,000 - 180,000; Full time

Benefits offered by this job

Medical/Dental/Vision coverage

401(k) with company match

Tuition Reimbursement

Daily Pay

Paid Time Off

Competitive market compensation

Short/Long Term Disability

Life Insurance

Employee Assistance Program

Job summary

Oceans Healthcare, L.L.C. in Louisiana seeks a Director of Utilization Management to supervise UM across inpatient, partial hospitalization, and outpatient programs.

Responsibilities include auditing medical records to ensure appropriate admissions and timely discharge planning, and coordinating with third-party payers with clinical staff for compliant care. The role emphasizes collaboration with medical teams, adherence to Joint Commission and state regulations, and driving performance

Responsibilities

• Oversee utilization review/case management for inpatient, partial hospitalization, and outpatient programs.
• Audit medical records to ensure admission/continued stay criteria are met and documented.
• Coordinate information between third-party payers and medical staff; ensure timely discharge planning.

Job description

Oceans Healthcare, L.L.C. in Louisiana seeks a Director of Utilization Management to supervise UM across inpatient, partial hospitalization, and outpatient programs.

Responsibilities include auditing medical records to ensure appropriate admissions and timely discharge planning, and coordinating with third-party payers with clinical staff for compliant care. The role emphasizes collaboration with medical teams, adherence to Joint Commission and state regulations, and driving performance