Utilization Management (UM) Director Jobs

The Utilization Management (UM) Director determines policies and procedures that incorporate best practices and ensure effective utilization reviews. Leads and directs the utilization review staff and function for a healthcare facility. Being a Utilization Management (UM) Director provides analysis and reports of significant utilization trends, patterns, and impacts to resources. Manages and monitors both concurrent reviews to ensure that the patient is getting the right care in a timely and cost-effective way and retrospective reviews after treatment has been completed. In addition, Utilizati ... on Management (UM) Director consults with physicians and other professionals to develop improved utilization of effective and appropriate services. Requires a master's degree. Typically reports to top management. Typically requires Registered Nurse(RN). The Utilization Management (UM) Director manages a departmental sub-function within a broader departmental function. Creates functional strategies and specific objectives for the sub-function and develops budgets/policies/procedures to support the functional infrastructure. Deep knowledge of the managed sub-function and solid knowledge of the overall departmental function. Working as a Utilization Management (UM) Director typically requires 5+ years of managerial experience. More
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