Utilization Management Director jobs in New York, NY

Exciting Opportunity for experienced RN Utilization Management Leaders! As a Full Time Director of Utilization Management at VillageCare, you will have the unique opportunity to showcase your expertise in driving operational efficiency and ensuring quality patient care on a fully remote basis. Join our team of dedicated professionals who are passionate about making a meaningful impact in the healthcare industry. If you are a smart problem solver with a customer-centric approach and a commitment to excellence and integrity, we want to hear from you.

Take the next step in your career with us and be part of a forward-thinking organization that values high performance and professionalism. The anticipated pay for this role is $132,000-$148,000 annually. You can get great benefits such as a generous PTO package, 10 Paid Holidays, Personal and Sick time, Medical/Dental/Vision, HRA/FSA, Education Reimbursement, Retirement Savings 403(b), Life and Disability, Commuter Benefits, Paid Family Leave, and Additional Employee Discounts. Apply now!

VillageCare: Who We Are

VillageCare is a community-based, not-for-profit organization serving people with chronic care needs, as well as seniors and individuals in need of continuing care and managed care services. Our mission is to promote healing, better health and well-being to the fullest extent possible. Our care is offered through a comprehensive array of community and residential programs, as well as managed care. VillageCare has delivered quality health care services to individuals residing within New York City for over 45 years.

What's your day like?

As a new Director of Utilization Management at VillageCare, you can expect to oversee the utilization review process, collaborate with interdisciplinary teams to optimize patient care, and develop strategies to enhance operational efficiency. Your day-to-day responsibilities will involve conducting utilization reviews, analyzing data trends, and implementing best practices to ensure cost-effective and high-quality care delivery. This role will require you to lead a team of utilization management professionals, provide guidance on complex cases, and communicate effectively with stakeholders. The expected schedule for this position is Monday through Friday from 9:00am to 5:00pm EST.

Join us in this dynamic role and make a difference in healthcare management!

Would you be a great Director of Utilization Management?

To excel as the Director of Utilization Management at VillageCare, you must possess exceptional leadership skills to direct the day-to-day operations effectively. Proficiency in overseeing concurrent reviews, discharge planning, and prior authorization functions is crucial. You should have a strong background in developing and implementing utilization management programs that enhance cost efficiency and quality of care.

Expertise in maintaining staff productivity, compliance, and training is essential for success in this role. The ideal candidate will have a Bachelor's Degree, with a Master's Degree preferred, and an active NYS (RN, NP, PA, or MD) license. A minimum of 5 years of management experience in a health-related field, along with 3 years in a quality management position, is required.

Strong analytical skills and knowledge of regulatory requirements for Medicare and Medicaid plans are necessary to drive improvement activities effectively. Join us and make a meaningful impact in healthcare management!

Connect with our team today!

We believe in taking care of our team, both on and off the job. That's why we offer a mobile-friendly application process - because we know your time is valuable. If you're ready to take your management skills to the next level and join a team that values hard work and good times, complete our application today!

VillageCare is an Equal Opportunity Employer.