RN Director of Utilization Management

Job Summary

Leading a nationwide Post-Acute Care Utilization Management team, the full-time RN Director of Utilization Management will oversee daily operations, ensure compliance with policies and standards, and drive performance improvements to achieve optimal member outcomes in a remote setting.

Key responsibilities

• Directs the utilization management team to ensure compliance with corporate and regulatory standards
• Analyzes utilization trends and implements process improvements for cost-effective healthcare results
• Manages onboarding, hiring, and training of new team members to enhance care quality and compliance

Required qualifications

• Bachelor's degree and 7+ years of related experience, including management experience
• 4+ years of management experience preferred
• Expert knowledge of industry regulations, policies, and standards preferred
• Active RN license or Compact State Licensure preferred