Utilization Management Director - RN

Job Summary

A company is looking for a Utilization Management Director - RN Required - Remote.

Key Responsibilities

• Oversee day-to-day operations of the Utilization Management Department to ensure compliance with payer requirements and regulatory standards
• Monitor and analyze key performance indicators (KPIs) and financial goals to drive performance improvements
• Recruit, train, and manage a high-performing UM team, ensuring alignment with hospital objectives

Required Qualifications

• Registered Nurse licensure; UR specific certification preferred (CCM, ACM, CPUR)
• Bachelor's Degree required
• Minimum of 7 years of Utilization Review experience with at least 2 years in Revenue Cycle leadership
• Master's Degree in Nursing or related health field preferred
• Proven ability to lead teams and manage budgets effectively