Senior Director, Utilization Management and Care Coordination

1 week ago


Seattle, Washington, United States Community Health Plan of Washington Full time
Job Summary

We are seeking a highly experienced Senior Director to lead our Utilization Management and Care Coordination team. The ideal candidate will have a strong background in healthcare management, with a focus on utilization review, care coordination, and quality improvement.

The Senior Director will be responsible for developing and implementing strategies to improve patient outcomes, reduce healthcare costs, and enhance the overall quality of care. This will involve working closely with our medical directors, care managers, and other stakeholders to ensure seamless coordination and operational workflows.

The successful candidate will possess excellent leadership and communication skills, with the ability to translate strategy into action. They will also have a strong analytical mindset, with the ability to collect and analyze data to inform decision-making.

Key Responsibilities

  • Develop and implement utilization management and care coordination strategies to improve patient outcomes and reduce healthcare costs
  • Lead a team of medical directors, care managers, and other stakeholders to ensure seamless coordination and operational workflows
  • Collaborate with healthcare economics and other departments to analyze data and inform decision-making
  • Develop and monitor key performance indicators to ensure timely reporting to internal committees and leadership
  • Oversee the development and monitoring of annual department budgets

Requirements

  • Master's degree in nursing or other relevant field
  • Minimum 10 years of experience in utilization management or related managed care experience
  • Minimum 5 years of experience in leadership roles, with a focus on utilization management and care coordination
  • Excellent leadership and communication skills
  • Strong analytical mindset, with the ability to collect and analyze data to inform decision-making


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