Utilization Management Program Director

6 days ago


Los Angeles, California, United States Management Business Solutions Full time
Job Title: Utilization Management Program Director

Management Business Solutions is seeking a highly skilled Utilization Management Program Director to lead our team in providing exceptional patient care and ensuring cost-effective utilization of resources.

Key Responsibilities:
  • Develop and maintain policies and procedures for Utilization Management
  • Collaborate with multidisciplinary teams to plan and coordinate care across the continuum
  • Coordinate and manage member care with non-KFH hospital facilities and providers
  • Identify risk management and quality of care issues across the continuum
  • Manage transportation program to ensure appropriate utilization of resources
  • Assure compliance with Federal, State, TJC, NCQA, and internal standards and requirements
  • Provide direction to staff regarding utilization review, care coordination, discharge planning, and other services
Requirements:
  • Minimum three years of experience in utilization management and discharge planning in an acute care setting
  • BSN or bachelor's degree in healthcare-related field
  • Registered Nurse License (California)
Preferred Qualifications:
  • Certified Case Manager
  • Master's Degree
  • Management experience in a union environment
Benefits:
  • 401(k) matching
  • Dental insurance
  • Disability insurance
  • Employee assistance program
  • Flexible schedule
  • Flexible spending account
  • Free parking
  • Health insurance
  • Health savings account
  • Life insurance
  • Loan repayment program
  • Paid time off
  • Parental leave
  • Professional development assistance
  • Referral program
  • Relocation assistance
  • Retirement plan
  • Travel reimbursement
  • Tuition reimbursement
  • Vision insurance


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