Upvote
Downvote
Senior Director, Utilization Management & Transitional Care
Share Job
- Suggest Revision
$150
- This role drives vision and strategy for the integrated medical and behavioral utilization management/ transitional care programs, including overall planning, program and budget development, program implementation, and coordination to achieve quality and service-driven objectives.
- Have a current, unrestricted license in the State of Washington as an RN or ARNP (required)
- Have experience with regulatory and accreditation (i.e. State, Federal, NCQA accreditation) standards for utilization management (required)
- Knowledge of the various components of managed care operations and the linkages between them (quality improvement, disease management, population health management, care management, and claims operations)
- Leads systematic and comprehensive utilization management program that incorporates intake, clinical review, medical necessity, discharge planning, and post discharge support for physical and behavioral health services, including written policies and procedures that ensure regulatory compliance with State (HCA), Federal (CMS), NCQA and other oversight entities.
Active Job
Updated TodaySimilar Job
Relevance
Active