Job Summary
A healthcare company is filling a position for a Remote Utilization Management Director.
Core Responsibilities Include:
- Hiring, onboarding and directing local, market focused utilization management staff
- Monitoring, driving, and improving quality of daily utilization management work flows
- Developing and adopting best practice methodologies and training programs
Position Requirements Include:
- Previous experience in management
- 2-4 years of operations and Utilization Management experience
- Experience in population management, managed care or hospital medical management
- Proven ability to manage client relationships and achieve change
- Working knowledge of clinical quality metrics such as HEDIS, NCQA and National Quality Forum metrics
- Sophisticated knowledge of clinical operations in managed care
