Utilization Management Director (RN)

The Utilization Management Director (RN) will lead the Utilization Management Department, overseeing prior authorizations, concurrent review, medical claims review, appeals and grievance, and staff management. This is a hybrid position with 1-2 days of in-service area work expected per month.

Requirements

• Knowledge of utilization management and clinical nursing principles and practices
• Title 22, Knox Keene, Medicaid, Medicare, entitlement programs, and related regulations
• The principles and practices of managed care and UM documentation requirements
• Ability to direct, manage, supervise, mentor, train and evaluate staff
• Collaborative management style, build rapport, and effectively manage internal and external business relationships

Benefits

• Medical, Dental and Vision Plans
• Ample Paid Time Off
• 12 Paid Holidays per year
• 401(a) Retirement Plan
• 457 Deferred Compensation Plan
• Robust Health and Wellness Program
• Onsite EV Charging Stations