Director of Utilization Review

2 weeks ago


Miramar, Florida, United States Memorial Healthcare System Full time
Job Summary

We are seeking a highly skilled and experienced Director of Utilization Review to join our team at Memorial Healthcare System. As a key member of our leadership team, you will be responsible for directing the department's activities and resources to ensure alignment with our mission, values, and objectives.

Key Responsibilities
  • Prepare and evaluate departmental budgets to ensure compliance with allocated funding.
  • Coordinate and direct internal/external audits to ensure regulatory compliance.
  • Plan and monitor staffing activities, including hiring, orienting, evaluating, disciplinary actions, and continuing education initiatives.
  • Manage and evaluate department operations, including information technologies, service level determination, and complaint management, to achieve performance and quality control objectives.
  • Develop and implement departmental goals, plans, and standards consistent with clinical, administrative, legal, and ethical requirements.
Requirements
  • Accredited Program: Nursing (Required)
  • Registered Nurse License (RN LICENSE) - State of Florida (FL)
Working Conditions

This role requires critical thinking skills, decisive judgment, and the ability to work with minimal supervision. You must be able to work in a stressful environment and take appropriate action. Excellent interpersonal skills are necessary.

Additional Information

This is a complex role that requires 5 years of leadership experience and 2 years of experience in utilization case management. If you are a motivated and experienced professional looking for a new challenge, we encourage you to apply.


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