About the role

  • Director overseeing utilization management to ensure best member outcomes and compliance in healthcare organization. Leading a team to achieve effective utilization strategies and improve member experiences.

Responsibilities

  • Directs the utilization management team to ensure the appropriate application of policy procedures and processes
  • Oversees and manages Utilization Operations specific to daily operations of Utilization Management
  • Leads utilization management team on performance, improvement, and career growth path considerations
  • Reviews, analyzes, and reports on utilization trends, patterns, and impacts
  • Develops utilization management strategies and influences decisions

Requirements

  • Requires a Bachelor's degree and 7+ years of related experience, including prior management experience
  • 4+ years management experience preferred
  • Expert knowledge of industry regulations, policies, and standards preferred
  • Ohio State RN license is required

Benefits

  • competitive pay
  • health insurance
  • 401K and stock purchase plans
  • tuition reimbursement
  • paid time off plus holidays
  • flexible approach to work with remote, hybrid, field or office work schedules

Job title

Director, Utilization Management

Job type

Experience level

Lead

Salary

$127,300 - $236,100 per year

Degree requirement

Bachelor's Degree

Location requirements

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