Utilization Management Director jobs in Kansas City, MO

Utilization Management Director leads and directs the utilization review staff and function for a healthcare facility. Determines policies and procedures that incorporate best practices and ensure effective utilization reviews. Being a Utilization Management Director manages and monitors both concurrent reviews to ensure that the patient is getting the right care in a timely and cost-effective way and retrospective reviews after treatment has been completed. Provides analysis and reports of significant utilization trends, patterns, and impacts to resources. Additionally, Utilization Management Director consults with physicians and other professionals to develop improved utilization of effective and appropriate services. Requires a master's degree. Typically reports to top management. Typically requires Registered Nurse(RN). The Utilization Management Director manages a departmental sub-function within a broader departmental function. Creates functional strategies and specific objectives for the sub-function and develops budgets/policies/procedures to support the functional infrastructure. Deep knowledge of the managed sub-function and solid knowledge of the overall departmental function. To be a Utilization Management Director typically requires 5+ years of managerial experience. (Copyright 2024 Salary.com)

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Medical Director, Utilization Management - Remote (Missouri)
  • UnitedHealth Group
  • Kansas, MO FULL_TIME
  • Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together.

     

    We are currently seeking an Inpatient Care Management Medical Director to join our Optum team. This team is responsible for conducting acute level of care and length of stay reviews for medical necessity for our members being managed within the continuum of care.  Our clients include local and national commercial employer, Medicare, and state Medicaid plans. The Medical Directors work with groups of nurses and support staff to manage inpatient care utilization at a hospital, market, regional or national level.  

    You’ll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges. 

     

    Primary Responsibilities:

    • Participate in telephonic outreach for collaboration with treating providers. This will include discussion of evidence - based guidelines, opportunities to close clinical quality / service gaps, and care plan changes that can impact health care expenses
    • Responsible to collaborate with operational and business partners on clinical and quality initiatives at the site and customer level to address customer expectations
    • Is grounded in the use and application of evidence-based medicine (EBM) such as InterQual care guidelines and criteria review 
    • Occasionally, may participate in periodic market oversight meetings with the outward facing Chief Medical Officers, network contractors, nurse management and other internal managers
    • Maintain proficiency in all required software and platforms
       

    Although the United Health Services ICM Medical Director's work is typically concentrated in a region, they are part of a national organization and team, and collaborate with peers, nurse managers, and non-clinical employees from across the country. In response to customer needs and expectations, Optum is continuously modifying its programs and approaches. Although not a primary job function, Medical Directors with the interest in doing so often can be involved with change design and management. 

     

    You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

    Required Qualifications:        

    • MD or DO with an active, unrestricted medical license in the state of Missouri
    • Reside in the state of Missouri
    • Current Board Certification in an ABMS or AOBMS specialty
    • 5 years of clinical practice experience post residency
    • Private home office and access to high-speed Internet
    • Technical proficiency in computer software and systems

     

    Preferred Qualifications:        

    • 2 years managed care, Quality Management experience and/or administrative leadership experience
    • UM experience
    • Clinical experience within the past 2 years
       

    *All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy

     

    California, Colorado, Connecticut, Hawaii, Nevada, New Jersey, New York, Rhode Island, or Washington Residents Only: The salary range for California, Colorado, Connecticut, Hawaii, Nevada, New Jersey, New York, Rhode Island, or Washington residents is $248, 582 to $338, 965 annually. Salary Range is defined as total cash compensation at target. The actual range and pay mix of base and bonus is variable based upon experience and metric achievement. Pay is based on several factors including but not limited to education, work experience, certifications, etc. In addition to your salary, UnitedHealth Group offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with UnitedHealth Group, you’ll find a far-reaching choice of benefits and incentives. 

     

    At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone–of every race, gender, sexuality, age, location and income–deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes — an enterprise priority reflected in our mission. 

     

     

    Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.

     

    UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.

  • 7 Days Ago

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Materials Management Utilization Analyst
  • St Lukes Health System (Kansas City MO)
  • Kansas, MO FULL_TIME
  • Job DescriptionAssist in establishing data collection processes and tools, and integrating data from multiple sources. Develop and interpret complex mathematical models and effectively present sophist...
  • 1 Day Ago

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Director of Health Information Management
  • Signature Psychiatric Hospital
  • Kansas, MO FULL_TIME
  • Overview We are looking for a Director of Health Inofrmation Management to join our team at Signature Psychiatric in North Kansas City! Signature Psychiatric Hospital offers inpatient and outpatient p...
  • 6 Days Ago

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Director of Claims Management
  • RAILCREW XPRESS LLC
  • Kansas, MO OTHER
  • Job Details Job Location: Corporate [1000] - North Kansas City, MO Salary Range: Undisclosed DescriptionThis position manages, coordinates, and monitors all claims involving company property, employee...
  • 17 Days Ago

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Director of Project Management
  • MULTIVAC USA
  • Kansas, MO FULL_TIME
  • Summary: Manage a team of Project Managers in the planning and execution of the project management function through allocating and assigning resources, overseeing team deliverables, facilitating commu...
  • 2 Months Ago

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Director of Rehabilitation
  • Anew Healthcare Management Llc
  • Springs, MO FULL_TIME
  • Anew Healthcare and Rehabilitation is a leading healthcare provider dedicated to delivering exceptional rehabilitation services to our residents. With a commitment to compassionate care and clinical e...
  • 10 Days Ago

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0 Utilization Management Director jobs found in Kansas City, MO area

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External Audit Professionals - Senior, Supervisor, Manager, Director and Partner level - REMOTE / Great Work-life balance and progression!
  • Taurus Search
  • Kansas City, MO
  • Audit & Assurance Professionals Wanted! 📊💼 Are you an External Audit Professional looking for a career that combines e...
  • 3/19/2024 12:00:00 AM

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Director of BESS Engineering | DC (open to remote) | Utility & DG BESS
  • Viridan Group
  • Kansas City, MO
  • Director of BESS Engineering | DC (open to remote) | Utility & DG BESS Are you a Snr Engineer in the energy storage spac...
  • 3/19/2024 12:00:00 AM

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Medical Director, Utilization Management - Remote (Missouri)
  • UnitedHealth Group
  • Kansas City, MO
  • Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. ...
  • 3/17/2024 12:00:00 AM

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Operating Room Supervisor
  • The University of Kansas Health System
  • Kansas City, KS
  • Position Title Operating Room Supervisor Bell Hospital Position Summary / Career Interest: Under the supervision of the ...
  • 3/16/2024 12:00:00 AM

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Tax Professionals - Senior, Supervisor, Manager, Director and Partner level - REMOTE / Great Work-life balance and progression!
  • Taurus Search
  • Kansas City, MO
  • Tax Professionals Wanted! 📊💼 Are you a Tax Professional looking for a career that combines expertise with flexibility?...
  • 3/15/2024 12:00:00 AM

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Tax Professionals - Senior, Supervisor, Manager, Director and Partner level - REMOTE / Great Work-life balance and progression!
  • Taurus Search
  • Kansas City, MO
  • Tax Professionals Wanted! 📊💼 Are you a Tax Professional looking for a career that combines expertise with flexibility?...
  • 3/15/2024 12:00:00 AM

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Sr. Program Manager/Director- REMOTE
  • Per Sé Group
  • Kansas City, MO
  • Senior Program Manager/Director for a Direct Hire/Remote role; U.S.-based renewable energy company that owns and operate...
  • 3/15/2024 12:00:00 AM

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Operations Finance Manager
  • TranSystems Corporation
  • Kansas City, MO
  • Overview: We are excited to share once again TranSystems has been recognized as a top 100 design firm by Engineering New...
  • 3/15/2024 12:00:00 AM

Kansas City is the largest city in the U.S. state of Missouri. According to the U.S. Census Bureau, the city had an estimated population of 488,943 in 2017, making it the 37th most-populous city in the United States. It is the central city of the Kansas City metropolitan area, which straddles the Kansas–Missouri state line. Kansas City was founded in the 1830s as a Missouri River port at its confluence with the Kansas River coming in from the west. On June 1, 1850 the town of Kansas was incorporated; shortly after came the establishment of the Kansas Territory. Confusion between the two ensued...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Utilization Management Director jobs
$123,852 to $167,471
Kansas City, Missouri area prices
were up 1.7% from a year ago

Utilization Management Director in Johnstown, PA
Prior authorization decisions are also made using Medical Management and Behavioral Health Care Management internally derived policies and procedures developed using evidence-based guidelines based on national, state and locally established standards of practice.
March 01, 2020
Utilization Management Director in Carson City, NV
The utilization management coordinator must have strong project management skills to implement various programs within the allocated budget and set time limits.
January 31, 2020
Utilization Management Director in Melbourne, FL
Develops and administers polices and procedures for utilization control of inpatient and outside referral services countywide and for in a variety of categorical programs including the Medically Indigent Adult (MIA) Program.
January 08, 2020