Utilization Management Director jobs in Portland, OR

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)

Recently Added Utilization Management Director jobs

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Director of Utilization Review
  • Springstone, Inc.
  • Vancouver, WA FULL_TIME

  • Overview

     

    Rainier Springs is a 72-bed behavioral hospital located in Vancouver, WA. The hospital offers inpatient and outpatient mental health and addiction treatment to adults, adolescents, and their families. At Rainier Springs we are dedicated to Changing People’s Lives®. 

     

    Rainier Springs is looking for an experienced Director of Utilization Review to join our team! This full-time position has a set schedule of 8AM to 5PM, Monday to Friday. Full-time employees are eligible for PTO, Paid Holidays, 401K, Insurance Benefits & more!

     

    The Utilization Review department plays an essential role in helping fulfill our mission of “Changing People’s Lives®”.  Utilization Review team members advocate on behalf of our patients to managed care providers for necessary treatment.  As a Utilization Review Director, you will ensure your team accurately and timely completes utilization review activities.

     

    Members of our team Enjoy:

    • Working with a highly engaged staff
    • Healthy staffing levels
    • Flexible scheduling
    • Career growth
    • Competitive compensation
    • UKG Wallet ? We?ve partnered with UKG Wallet, a voluntary Earned Wage Access benefit, to offer employees access to their pay on their own schedule.

    Position Details

    • Oversee the Utilization Review department, ensuring staff has completed all assignments and monitors performance.
    • Ensure all pre-certifications are completed for inpatient and outpatient services.
    • Monitor hospital LOS, reports appropriately, and educates other departments regarding their role in maintaining appropriate length of stay for all patients.
    • Assist with creation of treatment team agenda and participates to ensure team is aware of coverage info as well as collecting information for communication with insurance or other funding source
    • Interface with managed care organizations, external reviews, and other payers.

    Compensation and Benefits:

    Salary/Hourly: $ 44.23

    Rainier Springs Summary of Benefits

    Qualifications

    Requirements:

    • Bachelor’s degree or current clinical license strongly preferred
    • Current encumbered clinical licensure and valid drivers’ license
    • CPR and CPI Certification within 30 day of employment

    Experience:

    • Previous utilization review experience in a psychiatric healthcare facility preferred

     

     

  • 6 Days Ago
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Director of Utilization Review
  • Rainier Springs
  • Vancouver, WA FULL_TIME
  • Overview Rainier Springs is a 72-bed behavioral hospital located in Vancouver, WA. The hospital offers inpatient and outpatient mental health and addiction treatment to adults, adolescents, and their ...
  • 6 Days Ago
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Utilization Management Specialist – Posting #23-013
  • Lifeline Connections
  • Vancouver, WA FULL_TIME
  • Agency Background: Lifeline Connections is a not-for-profit agency that is recognized as a leading behavioral health treatment provider in Washington State, offering a full continuum of care for indiv...
  • 1 Month Ago
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Laboratory Utilization Management and Process Improvement Specialist
  • Labcorp
  • Portland, OR FULL_TIME
  • Using Labcorp’s commercial analytics tools, Visiun, this position will help identify and drive operational improvements in Legacy Health’s labs. The position will report to both Visiun leadership and ...
  • 1 Month Ago
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Specialist, Utilization Management-Mental Health (Remote - Must live in Oregon)
  • Kaiser Permanente
  • Portland, OR OTHER
  • Job Summary: Ensure consistent application and management of Kaiser Permanente mental health and chemical dependency benefits.Essential Responsibilities: Benefit payment authorizations. Manage behavio...
  • 11 Days Ago
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Event Director - 2448
  • Guardian Management
  • Portland, OR FULL_TIME
  • Guardian has an immediate need for a Full-Time Event Director to join our growing team at Slabtown Square!Slabtown Square is a new and exciting community with 200 units.The Event Director will play an...
  • 1 Month Ago
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0 Utilization Management Director jobs found in Portland, OR area

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Tax Professionals - Senior, Supervisor, Manager, Director and Partner level - REMOTE / Great Work-li
  • Taurus Search
  • Portland, OR
  • Tax Professionals Wanted! ???? Are you a Tax Professional looking for a career that combines expertise with flexibility?...
  • 4/26/2024 12:00:00 AM
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Energy Warehouse (EW) Program Director (or Manager)
  • ESS, Inc.
  • Wilsonville, OR
  • Energy Warehouse (EW) Program Director / Manager Wilsonville, OR The Energy Warehouse (EW) Program Director (or Manager)...
  • 4/26/2024 12:00:00 AM
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Director of Policy & Regulatory Affairs | Eastern US, REMOTE |$165k - $175k base + bonus
  • Consult Energy USA
  • Portland, OR
  • Director of Policy & Regulatory Affairs | Eastern US, REMOTE |$165k - $175k base + bonus Are you a regulatory affairs an...
  • 4/25/2024 12:00:00 AM
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REMOTE: Medical Director, Utilization Management and Medical Policy
  • Evry Health
  • Portland, OR
  • About the Role Evry Health is hiring a tech-savvy Medical Director to lead medical policy and utilization management. As...
  • 4/24/2024 12:00:00 AM
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Hope Chinese Charter School, Head of School
  • Edgility Consulting
  • Portland, OR
  • Earl Monroe New Renaissance Basketball School, High School Science Teachers Earl Monroe New Renaissance Basketball Schoo...
  • 4/24/2024 12:00:00 AM
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Director/ Senior Manager, Enterprise Sales
  • Cvent Inc.
  • Portland, OR
  • Overview:Cvent is a leading meetings, events, and hospitality technology provider with more than 4,800 employees and ~22...
  • 4/23/2024 12:00:00 AM
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Director, Product Management, Autodesk Construction Solutions
  • Autodesk
  • Portland, OR
  • **Job Requisition ID #** 24WD77123 **Position Overview** At Autodesk Construction Solutions, our mission is to help Cons...
  • 4/23/2024 12:00:00 AM
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Mid-Market Engagement (Account) Manager - Director
  • Prialto
  • Portland, OR
  • Job Overview: The Mid-Market Engagement Manager is responsible for managing and nurturing relationships with largest cus...
  • 4/22/2024 12:00:00 AM
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About Portland, Oregon

Portland is the largest and most populous city in the U.S. state of Oregon and the seat of Multnomah County. It is a major port in the Willamette Valley region of the Pacific Northwest, at the confluence of the Willamette and Columbia rivers. As of 2017, Portland had an estimated population of 647,805, making it the 26th-largest city in the United States, and the second-most populous in the Pacific Northwest (after Seattle). Approximately 2.4 million people live in the Portland metropolitan statistical area (MSA), making it the 25th most populous MSA in the United States. Its Combined Statist...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Utilization Management Director jobs
$131,879 to $178,327
Portland, Oregon area prices
were up 3.9% from a year ago
View detail

What does a Utilization Management Director do?

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