Utilization Management Director

Compensation: $140,000.00 - $180,000.00 per yearRequired Qualifications:AMI Network is partnered with a large healthplan organization to find their next Utilization Management Director in Pasadena.If your skills, experience, and qualifications match those in this job overview, do not delay your application.Our client is a leading Health Plan + IPA that offers full-service Medicare Advantage coverage across multiple counties in California, currently serving over 60k+ members from major Health Plans like Anthem, SCAN, and Alignment Health.As the Utilization Review Director, you'll oversee 4 direct reports on the IPA side (UM supervisors + coordinator), and play a crucial role in providing operational leadership to the UM/Prior Authorization and Inpatient Teams (50 FTEs in total). You'll be responsible for CMS + Health Plan audits, and ensuring compliance with Federal, State, Health Plan, and NCQA requirements.This role offers a competitive salary in the ballpark of $180k (give or take based on experience) -Plus great benefits: 3 weeks PTO, 8 Holidays, 401k + matching, HMO or PPO Medical/Dental, vision, and life insurance.This is an onsite position- no remote options are available at this time. xevrcycRequirements:Healthplan Experience + Medicare Advantage3-5 years Management ExperienceRN in CADaily audits of UM until they are in full compliance - CMS + Health Plan auditsAPPLY NOW if you're interested in taking the next big step in your career!