Director of Utilization Management
green key resourcesBrooklyn, NY
Director of Utilization Management
green key resourcesBrooklyn, NY
8 days ago
Industries
Offices of PhysiciansGeneral Medical and Surgical HospitalsNursing Care Facilities (Skilled Nursing Facilities)About the role
Director of Utilization Management (RN)- HybridRemote/Hybrid – 2 days per week in the office A growing healthcare organization is seeking an experienced Director of Utilization Management to lead its Medicare UM department. This is an exciting opportunity for a hands-on leader to oversee and develop the UM function as the department continues to expand.
Key Responsibilities:
- Lead day-to-day Utilization Management operations
- Oversee utilization review, case management, and precertification functions
- Develop and implement UM policies, procedures, and workflows
- Ensure compliance with CMS, Medicare, and applicable regulatory guidelines
- Monitor utilization trends, reporting, and department performance
- Lead, develop, and train the UM team
Qualifications:
- Active RN license
- Strong leadership experience in Utilization Management
- Direct Medicare Utilization Management experience is required
- Knowledge of CMS guidelines, InterQual, and Medicare regulations
- Experience managing teams and improving UM processes
- Interested candidates or referrals are encouraged to reach out for additional details!#Healthcare
- Jobs #Nursing
- Leadership #Utilization
- Management #Medicare #RNJobs #Healthcare
Leadership
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JOB OVERVIEW
Experience level
Manager
Location
Brooklyn, NY
Occupation
Medical and Health Services Managers
Industry
Offices of Physicians
Posted
8 days ago
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