Remote Director of Utilization Management - Physical Health

Alliance; United States; Remote; USD 119,000 - 152,000; Full time

Benefits offered by this job

Generous retirement savings plan

Flexible work schedules includinghyb/远

Paid time off including vacation, sick

Dress flexibility

Job summary

Alliance is seeking a Director of Utilization Management (Physical Health) to lead the UM team in a fully remote role with occasional travel to the Morrisville, NC home office. You will oversee utilization management for physical health, ensure adherence to policies, and drive performance across the department.

The role requires RN licensure (BSN or MSN preferred) and several years of supervisory UM experience within a healthcare setting.

Qualifications

• RN with a Bachelor's or Master's in Nursing.
• Seven years post-degree experience with supervisory and UM experience.
• Knowledge of NC DHB, DMH contracts and accrediting standards.

Responsibilities

• Lead and manage the UM unit for physical health.
• Ensure compliance with licensure, regulatory, and accreditation requirements.
• Oversee vendors and utilization reviews to ensure quality outcomes.
• Develop systems to monitor utilization and address gaps.

Skills

Utilization Management

Data analysis

Workflow development

Communication

Leadership

Team collaboration

Education

Bachelor's in Nursing

Master's in Nursing

Tools

Microsoft Office

Job description

Alliance is seeking a Director of Utilization Management (Physical Health) to lead the UM team in a fully remote role with occasional travel to the Morrisville, NC home office. You will oversee utilization management for physical health, ensure adherence to policies, and drive performance across the department.

The role requires RN licensure (BSN or MSN preferred) and several years of supervisory UM experience within a healthcare setting.