Utilization Management Director jobs in Lebanon, PA

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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Utilization Management Specialist - Utilization Management
  • Penn State Health
  • Hershey, PA FULL_TIME
  • Penn State Health - Milton S. Hershey Medical Center

    Location : US:PA: Hershey
    Work Type : Full Time
    FTE : 0.90
    Shift : Day
    Hours : 9:00a - 9:30p


    SUMMARY OF POSITION :

    Responsible for the review of clinical documentation in the Electronic Medical Record (EMR), comparing it to the nationally accepted and evidence-based criteria to certify an admission to the facility, and for concurrent/continued stay review as appropriate. Also responsible for maintaining compliance with the CMS Conditions of Participation for Utilization Management.

    MINIMUM QUALIFICATIONS:

    Bachelor's Degree in Nursing or Master's Degree in Nursing required 3 years

    Advanced clinical experience in a hospital setting required.

    Currently licensed to practice as a registered nurse by Pennsylvania Board of Nurse Examiners required.

    Demonstrated ability to problem-solve complex, multidimensional situations required.

    Ability to successfully manage conflict and negotiate "win-win" solutions required.

    Strong organizational, task prioritization and delegation skills required.

    Strong oral and written communication skills required.

    Ability to work independently required.

    PREFERRED QUALIFICATIONS:

    Financial Counseling experience preferred.


    This job description is a general outline of duties performed and is not to be misconstrued as encompassing all duties performed within the position. All individuals (including current employees) selected for a position will undergo a background check appropriate for the position's responsibilities.

    Penn State Health is fundamentally committed to the diversity of our faculty and staff. We believe diversity is unapologetically expressing itself through every person's perspectives and lived experiences. We are an equal opportunity and affirmative action employer. All qualified applicants will receive consideration for employment without regard to age, color, disability, gender identity or expression, marital status, national or ethnic origin, political affiliation, race, religion, sex (including pregnancy), sexual orientation, veteran status, and family medical or genetic information. If you are unable to use our online application process due to an impairment or disability, please call 717-531-8440 between the hours of 7:30 AM and 4:30 PM, Eastern Standard Time, Monday through Friday, email hrsolutions@pennstatehealth.psu.edu or download our Accommodation Instructions for Job Applicants PDF for more detailed steps for assistance.

    Union : SEIU Healthcare Pennsylvania

  • 6 Days Ago

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Utilization Management Specialist - DAY SHIFT - Utilization Management
  • Penn State Health
  • Hershey, PA FULL_TIME
  • Penn State Health - Hershey Medical Center Location: US:PA:Hershey Work Type: Full Time FTE: 1.00 Shift: Day Hours: 8:00a - 4:30p Recruiter Contact : Denisse Rosado at drosado1@pennstatehealth.psu.edu...
  • 1 Month Ago

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Specialist (Part-time) - Utilization Management
  • Penn State Health
  • Hershey, PA PART_TIME
  • Penn State Health - Milton S. Hershey Medical Center Location : US:PA: Hershey Work Type : Part Time FTE : 0.50 Shift : Day Hours : 8-Hour Shifts SUMMARY OF POSITION : Responsible for the review of cl...
  • 19 Days Ago

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Specialist (Part-time) - VARIED SHIFTS - Utilization Management
  • Penn State Health
  • Hershey, PA PART_TIME
  • Penn State Health - Hershey Medical Center Location: US:PA: Hershey Work Type: Part-Time FTE: 0.50 Shift: Varied Hours: 8:00a - 4:30p Recruiter Contact : Denisse Rosado at drosado1@pennstatehealth.psu...
  • 1 Month Ago

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Director of Enrollment Management
  • LINDEN HALL
  • Lititz, PA FULL_TIME
  • Linden Hall is currently looking for a Director of Enrollment Management. This position is responsible for developing and implementing comprehensive, action-oriented enrollment strategies and tactics ...
  • 17 Days Ago

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Activities Director
  • Cardinal Senior Management
  • Danville, PA FULL_TIME
  • Looking for a fun job where you truly make a difference in people's lives? Look no further than Vintage Knolls. We are looking for an Activities Director for our facility of vibrant senior residents! ...
  • 7 Days Ago

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0 Utilization Management Director jobs found in Lebanon, PA area

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Associate Director, Specimen Management - Eurofins Central Laboratory
  • Eurofins
  • Lancaster, PA
  • Eurofins Scientific is an international life sciences company, providing a unique range of analytical testing services t...
  • 4/23/2024 12:00:00 AM

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ADMIN ASSISTANT - F&B Hotel Hershey
  • Hersheyjobs
  • Hershey, PA
  • ADMIN ASSISTANT - F&B Hotel Hershey- Hershey You are here: / ADMIN ASSISTANT - F&B Hotel Hershey- Hershey | | ADMIN ASSI...
  • 4/23/2024 12:00:00 AM

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Associate Accountant
  • Boyer & Ritter
  • Camp Hill, PA
  • Job Description Job Description It is an exciting time at Boyer & Ritter! We are growing and seeking to bring on more of...
  • 4/22/2024 12:00:00 AM

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Human Resources Assistant - Inpatient Rehab
  • Select Medical Corporation
  • Hummelstown, PA
  • Overview Penn State Health Rehabilitation Hospital [A Joint Venture with Select Medical and Penn State Health] Hummelsto...
  • 4/22/2024 12:00:00 AM

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RETAIL AREA MANAGER
  • Hersheyjobs
  • Hershey, PA
  • RETAIL AREA MANAGER- Hershey You are here: / RETAIL AREA MANAGER- Hershey | | RETAIL AREA MANAGER Location: Hersheypark ...
  • 4/21/2024 12:00:00 AM

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Human Resources Assistant - Inpatient Rehab
  • Penn State Health Rehab Hospital
  • Hummelstown, PA
  • Overview: Penn State Health Rehabilitation Hospital [A Joint Venture with Select Medical and Penn State Health] Hummelst...
  • 4/20/2024 12:00:00 AM

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Associate Director, Specimen Management - Eurofins Central Laboratory
  • Eurofins
  • Lancaster, PA
  • Eurofins Scientific is an international life sciences company, providing a unique range of analytical testing services t...
  • 4/19/2024 12:00:00 AM

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Leasing Consultant
  • Property Management Enterprises LLC
  • Harrisburg, PA
  • Job Description Job Description The Apartment Gallery is the property management division of Property Management Enterpr...
  • 4/19/2024 12:00:00 AM

Lebanon (/ˈlɛbənən/) is a city in and the county seat of Lebanon County, Pennsylvania, United States. The population was 25,477 at the 2010 census, a 4.2% increase from the 2000 count of 24,461. Lebanon is located in the central part of the Lebanon Valley, 26 miles (42 km) east of Harrisburg and 29 miles (47 km) west of Reading. Lebanon was founded by George Steitz in 1740 and was originally named Steitztown. According to the United States Census Bureau, the city has a total area of 4.2 square miles (11 km2), all of it land. Lebanon is bordered to the north and east by North Lebanon Township (...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Utilization Management Director jobs
$122,893 to $166,176
Lebanon, Pennsylvania area prices
were up 1.5% 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