Director of Utilization Management
green key resourcesBrooklyn, NY
Director of Utilization Management
green key resourcesBrooklyn, NYManager L7
Offices of PhysiciansGeneral Medical and Surgical HospitalsNursing Care Facilities (Skilled Nursing Facilities)
APPLY NOW (opens in a new tab)Director of Utilization Management (RN)- HybridRemote/Hybrid – 2 days per week in the office A growing healthcare organization is seeking an experienced Director of Utilization Management to lead its Medicare UM department. This is an exciting opportunity for a hands-on leader to oversee and develop the UM function as the department continues to expand.
Key Responsibilities:
- Lead day-to-day Utilization Management operations
- Oversee utilization review, case management, and precertification functions
- Develop and implement UM policies, procedures, and workflows
- Ensure compliance with CMS, Medicare, and applicable regulatory guidelines
- Monitor utilization trends, reporting, and department performance
- Lead, develop, and train the UM team
Qualifications:
- Active RN license
- Strong leadership experience in Utilization Management
- Direct Medicare Utilization Management experience is required
- Knowledge of CMS guidelines, InterQual, and Medicare regulations
- Experience managing teams and improving UM processes
- Interested candidates or referrals are encouraged to reach out for additional details!#Healthcare
- Jobs #Nursing
- Leadership #Utilization
- Management #Medicare #RNJobs #Healthcare
Leadership
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Level
Manager L7
Location
Brooklyn, NY
Occupation
Medical and Health Services Managers
Industry
Offices of Physicians
Posted
8 days ago