Assistant Director of Admissions overseeing campus admissions operations at MyComputerCareer, driving recruitment and ensuring compliance with educational regulations and standards.
About the role
- Director of Utilization Review at Bradford Health Services optimizing resource use and ensuring compliance in healthcare delivery. Leading multidisciplinary teams and driving improvement initiatives in utilization management.
Responsibilities
- Lead and manage the utilization review department, ensuring timely and accurate clinical reviews in accordance with regulatory and accreditation standards.
- Develop and implement policies, procedures, and protocols to standardize utilization management practices across the organization.
- Collaborate with clinical teams, case managers, and external payers to facilitate appropriate care delivery and resolve utilization-related issues.
- Analyze utilization data and trends to identify opportunities for process improvements and cost containment.
- Provide training, mentorship, and performance evaluations for utilization review staff to maintain high levels of clinical competency and compliance.
- Ensure adherence to all federal, state, and payer regulations related to utilization review and healthcare compliance.
- Serve as a subject matter expert on utilization management during audits, accreditation surveys, and internal reviews.
- Partner with quality improvement and risk management teams to integrate utilization review findings into broader organizational initiatives.
Requirements
- Bachelor’s degree in Nursing, Health Administration, or a related healthcare field.
- Minimum of 5 years of progressive experience in utilization review, case management, or healthcare operations.
- Strong knowledge of healthcare regulations, payer policies, and accreditation standards related to utilization review.
- Demonstrated ability to analyze clinical data and implement process improvements.
- Master’s degree in Nursing, Healthcare Administration, Public Health, or a related field (preferred).
- Leadership experience managing clinical teams in a utilization management or related environment (preferred).
- Certification in Case Management (CCM), Utilization Review (URAC), or related professional credentials (preferred).
- Experience working within managed care organizations or health insurance companies (preferred).
- Proficiency with healthcare data analytics tools and electronic health record (EHR) systems (preferred).
- Familiarity with value-based care models and population health management (preferred).
Benefits
- Medical Coverage – Three new BCBSAL medical plans with better rates, improved co-pays, and enhanced prescription benefits.
- Expanded Coverage – Options for domestic partners and a wider network of in-network providers.
- Mental Health Support – Improved access to services and a new Employee Assistance Program (EAP) featuring digital wellness tools like Cognitive Behavioral Therapy (CBT) modules and wellness coaching.
- Voluntary Coverages – Pet insurance, home and auto insurance, family legal services, and more.
- Student Loan Repayment – Available for nurses and therapists.
- Retirement Benefits – 401(k) plan through Voya to help employees plan for the future.
- Generous PTO – A robust paid time off policy to support work-life balance.
- Voluntary Benefits for Part-Time Employees – Dental, vision, life, accident insurance, and telehealth options for those working 20 hours or more per week.
Job title
Job type
Experience level
Salary
Not specified
Degree requirement
Location requirements
Area Director managing facilities operations at Urban Pathways, supporting vulnerable NYC residents. Collaborating with teams to ensure safety, maintenance, and compliance across multiple buildings.
Director of Development at BRIDGE leading a team in multi - family real estate projects. Managing project execution, budgets, and stakeholder collaboration in Northern California.
Hybrid Director position managing pharmacy consulting engagements and driving performance improvements. Overseeing client relationships and providing compounding expertise to a healthcare advisory firm.
Director of Member Insights & Growth Strategy leveraging data - driven insights for member engagement and growth in a financial institution. Leading analytics strategy and informing product development.
Manufacturing Market Segment Director for Amerisure focusing on strategic direction and profitable growth in the manufacturing segment. Collaborating across teams to enhance product and market positioning.
Director of Pharmacy leading the strategic direction of the Culinary Health Fund’s pharmacy programs. Managing clinical pharmacy operations while ensuring compliance and financial objectives are met.
Store Director leading luxury retail team at Ferragamo's Beverly Hills location. Focused on customer experience and team development in high - end fashion.
Assistant Director of Admissions leading the admissions process at The Dorm, a mental health organization. Ensuring timely client intake and providing support to families and clients throughout the process.
Technical Director overseeing technical strategies and team collaboration at Virtuos. Leading game development projects with a focus on quality and performance in a hybrid environment.