Utilization Management Director jobs in Modesto, CA

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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Activity Director
  • Reliant Management
  • Turlock, CA FULL_TIME
  • POSITION SUMMARY:

        The Activity Director supports the facility by planning, implementing and evaluating the activities provided to each resident in association with the interdisciplinary team.

     

    RESPONSIBILITIES/ACCOUNTABILITIES:

    1.    Plans, implements, directs and evaluates the Activity Programs to ensure all residents’ assessed needs are met.   

    2.    Interviews residents/families as necessary in a private setting, provides information regarding activity programs and involves them in planning activities when possible.

    3.    Completes a comprehensive assessment of the activity needs of each resident including background, interests, abilities, physical and mental limitations, and strengths.  Ensures that a current resident activity schedule is maintained for each resident. Coordinates with the Nurse in assisting resident with selection of activity in compliance with physician's orders.

    4.    Maintains contact with the resident's family, involving them with non-medical progress reports as necessary.

    5.    Develops monthly activity calendar providing a variety of activities are available to meet the needs of the residents. Ensures calendars are posted/distributed by the 1st of the month.  Posts changes to calendar in accordance with state and federal regulations.

    6.    Conducts and/or supervises both group and one-on-one activities.

    7.    Provides adapted material for the impaired residents including but not limited to Braille reading material, tapes and records to ensure maximum participation in activities. 

    8.    Assists in providing library service for residents in cooperation with local library.

    9.    Schedules movies, plans parties and provides games for residents.

    10. Assists residents who are confined to bed by visiting with them, writing letters, running errands, making appointments, etc., as necessary.

    11. Encourages hobbies and provides materials in keeping with resident’s financial status and department budget.

    12. Encourages residents to participate in religious activities through religious services, reading material, visits with chaplain, etc., to fulfill their basic religious needs.

    13. Check supplies to assure that needed supplies and equipment are on hand to conduct scheduled activities. Places orders for equipment and supplies with approved vendors as necessary within budgetary parameters.

    14. Is alert for any change in the resident's condition. Reports any noted changes to Nurse immediately.

    15. Performs documentation duties as required and in accordance with Company policies and procedures and government regulations. Ensures documentation is accurate, informative and descriptive of the resident's condition, care provided and resident's response to the care.

    16. Participates in discharge planning when appropriate.

    17. Participates in community planning related to the interests of the facility and the services and needs of the resident and family.

    18. May arrange for exhibit or sale of articles made by residents i.e., at bazaars, in gift shop, etc.

    19. May make appointments for the resident as needed.

    20. Assists in arranging transportation for field trips and to other facilities when necessary.

    21. Provides consultation to members of our staff, community agencies, etc., in efforts to address the needs and problems of the resident through the development of activity/social service programs.

    22. Maintains an excellent working relationship with the medical profession and other health related facilities and organizations.

     

    The above listing of duties and responsibilities is not intended to be all-inclusive but rather to serve as a description of the range of duties and general nature of the position.  Nothing in this job description restricts management’s right to assign or reassign duties and responsibilities to this job at any time.

     

     

    SPECIFIC EDUCATION/VOCATIONAL REQUIERMENTS:

    1.    Associate degree with a minimum of two (2) years’ experience in Long Term Care or human services. These guidelines may vary according to State regulations.

    2.    Knowledge of Title 22 and OBRA regulations as they relate to long term care.

    3.    Any certification/licensure required by state regulations.

     

     

     

  • 7 Days Ago

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Director of Nursing
  • Reliant Management
  • Ceres, CA FULL_TIME
  • DON Director of Nursing What We’re Looking For: We’re looking for a dynamic Director of Nursing to lead our clinical team and provide our residents with an exceptional care experience. We need you to ...
  • 2 Months Ago

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Director of Nursing
  • Reliant Management
  • Turlock, CA FULL_TIME
  • DON Director of Nursing What We’re Looking For: We’re looking for a dynamic Director of Nursing to lead our clinical team and provide our residents with an exceptional care experience. We need you to ...
  • 2 Months Ago

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DSD Director of Staff Development
  • Reliant Management
  • Turlock, CA FULL_TIME
  • DSD Director of Staff Development What We’re Looking For: We are seeking to hire a self-motivated, efficient, responsible Licensed Vocational Nurse, to serve as Director of Staff Development and succe...
  • 5 Days Ago

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Social Services Director
  • Reliant Management
  • Turlock, CA FULL_TIME
  • Social Services Director What We’re Looking For: We’re currently looking for a Social Services Director to plan, develop, organize and evaluate the overall operations of our Social Services Department...
  • 1 Month Ago

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Director, Risk Management
  • The Save Mart Companies
  • Modesto, CA FULL_TIME
  • ABOUT US The Save Mart Companies is one of the largest food retailers in California and Nevada. It is home to several well-known brands in food retailing. You might have seen our stores that include S...
  • 23 Days Ago

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0 Utilization Management Director jobs found in Modesto, CA area

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Community Association Manager
  • The Cooper Company
  • Modesto, CA
  • Job Title: Community Association Manager Location: Modesto Company Description: The Cooper Company is a leading property...
  • 4/19/2024 12:00:00 AM

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Capital Projects Manager
  • City of Oakdale
  • Oakdale, CA
  • Capital Projects Manager Public Services Department The City of Oakdale, California has an exciting career opportunity f...
  • 4/19/2024 12:00:00 AM

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Community Association Manager
  • The Cooper Company
  • Modesto, CA
  • Job Title: Community Association Manager Location: Modesto Company Description: The Cooper Company is a leading property...
  • 4/18/2024 12:00:00 AM

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Operations Manager
  • Koch Industries
  • Modesto, CA
  • Georgia-Pacific's Corrugated division is searching for an Operations Manager for our facility located in Modesto, CA. Th...
  • 4/18/2024 12:00:00 AM

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Chief Financial Officer
  • Community Hospice
  • Modesto, CA
  • Job Description Job Description At Community Hospice & Health Services you will find a family-based and compassionate wo...
  • 4/18/2024 12:00:00 AM

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EXECUTIVE DIRECTOR
  • FAMILY PROMISE OF MODESTO
  • Modesto, CA
  • Job Description Job Description We are currently looking for a new Executive Director (ED) with strong management, progr...
  • 4/18/2024 12:00:00 AM

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General Manager Operations - Large CPG Company - New Facility
  • aerīz
  • Riverbank, CA
  • Aeriz Holdings Corp., a multi-state, award-winning leader in the cannabis industry, is hiring a General Manager in River...
  • 4/16/2024 12:00:00 AM

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General Manager Operations - Large CPG Company - New Facility
  • Aeriz
  • Riverbank, CA
  • Aeriz Holdings Corp., a multi-state, award-winning leader in the cannabis industry, is hiring a General Manager in River...
  • 4/16/2024 12:00:00 AM

Modesto /məˈdɛstoʊ/ (Spanish for "modest"), officially the City of Modesto, is the county seat and largest city of Stanislaus County, California, United States. With a population of approximately 201,165 at the 2010 census, it is the 18th largest city in the state of California and forms part of the Modesto–Merced combined statistical area. The Modesto Census County Division, which includes the cities of Ceres and Riverbank, had a population of 312,842 as of 2010[update]. Modesto is located in the Central Valley, 90 miles (140 km) north of Fresno, 40 miles (64 km) north of Merced, California, ...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Utilization Management Director jobs
$134,663 to $182,092
Modesto, California area prices
were up 2.5% 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