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Utilization Management Program Director

1 month ago

Ontario, California, United States Kaiser Permanente Full time
Job Summary:
As a key member of the Kaiser Permanente team, the Utilization Management Manager plays a critical role in ensuring the efficient and effective delivery of patient care. This position is responsible for managing the day-to-day operations of the Utilization Management Program, ensuring that resources are utilized in a cost-effective and quality-driven manner.

The ideal candidate will have a strong background in healthcare operations and management, with experience in utilization review, care coordination, and discharge planning. This individual will be responsible for providing direction to staff, collaborating with multidisciplinary teams, and identifying risk management and quality of care issues.

Key responsibilities include:

  • Developing and maintaining policies and procedures related to Utilization Management.
  • Collaborating with multidisciplinary teams to plan and coordinate care across the continuum.
  • Managing member care with non-Kaiser Permanente providers and facilities.
  • Identifying risk management and quality of care issues and surfacing them to the appropriate teams.
  • Managing the transportation program to ensure appropriate utilization of resources.

The successful candidate will have a strong understanding of healthcare regulations, including TJC, NCQA, and other regulatory agencies. This individual will also possess excellent interpersonal, negotiation, and management skills, with the ability to work effectively in a Labor/Management Partnership environment.

If you are a motivated and experienced healthcare professional looking for a challenging and rewarding opportunity, please consider applying for this position.