| Utilization Management Director Job Description |
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| The following is a full job description for Utilization Management Director. Here are the requirements and responsibilities for Utilization Management Director along with statistics. If after reading this page you determine that Utilization Management Director is not the position you are looking for, you may want to try one of these similar titles: Risk Management Director, Account Management Director, Project Management Director, Product Management Director, Category Management Director, Equipment Director, Program Management Office Director, Product/Brand Management Director, Medical Management Director |
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| Requirements and Responsibilities For Utilization Management Director |
| Leads and directs the utilization review staff and function for a healthcare facility. Determines policies and procedures that incorporate best practices and ensure effective utilization reviews. Manages and monitors both concurrent reviews to ensure that the patient is getting the right care in a timely and cost-effective way and retrospective reviews after treatment has been completed. Provides analysis and reports of significant utilization trends, patterns, and impacts to resources. Consults with physicians and other professionals to develop improved utilization of effective and appropriate services. Requires a master's degree. Typically reports to top management. Typically requires Registered Nurse(RN). Manages a departmental sub-function within a broader departmental function. Creates functional strategies and specific objectives for the sub-function and develops budgets/policies/procedures to support the functional infrastructure. Deep knowledge of the managed sub-function and solid knowledge of the overall departmental function. Typically requires 5+ years of managerial experience. |
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| Also referred to as: Patient Care Utilization Monitoring/Review Coordinator (RN), Utilization Management (UM) Director |
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| Similar Jobs: Risk Management Director, Account Management Director, Project Management Director, Product Management Director, Category Management Director, Equipment Director, Program Management Office Director, Product/Brand Management Director, Medical Management Director |
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| Level of Education: Utilization Management Director Salaries with a Master's Degree or MBA, Utilization Management Director Salaries with a JD, MD, PhD or Equivalent |
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| Industries: Edu., Gov't. & Nonprofit, Healthcare, Insurance | |
