Utilization Management Director jobs in Santa Barbara, 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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Health Plan Nurse Coordinator- Adult Utilization Management
  • CenCal Health
  • Goleta, CA FULL_TIME
  • The Health Plan Nurse Coordinator (HPNC) is at the minimum, a Licensed Vocational Nurse or a Registered Nurse who is assigned to one of several Health Services’ operational units. These units include, but are not limited to, the Utilization Management, Case Management, Disease Management, Pediatric-Whole Child Model, and Quality Improvement programs. This position reports to the Program’s Manager or their designee of the assigned unit. Depending on unit assignment, the HPNC may perform utilization management activities, which may include telephonic or onsite clinical review; case or disease management, care coordination or transition, or quality improvement activities; or a combination of all. The HPNC may be assigned to sub-specialized programs within an operational unit, such as Mental/Behavioral Health services. These sub-specialized programs require the RN to perform UM or CM activities for a specific member population.  Bilingual in Spanish may be required for positions that primarily requires interaction with members.

  • 1 Month Ago

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Health Plan Nurse Coordinator I - Case Management - Utilization Management Pediatric Program
  • CenCal Health
  • Santa Barbara, CA FULL_TIME
  • California Annual Salary Range: $82,165 - $119,140 Job Summary The Health Plan Nurse Coordinator (HPNC) is a Registered Nurse assigned to theUtilization Management and Case Management units. This posi...
  • 16 Days Ago

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Health Plan Nurse Coordinator I - Case Management - Utilization Management Pediatric Program
  • CenCal Health
  • Santa Barbara, CA OTHER
  • Job Details Job Location: Main Office - Santa Barbara, CA Position Type: Full Time Education Level: Bachelor's Degree Salary Range: Undisclosed Job Category: Medical Management DescriptionCalifornia A...
  • 18 Days Ago

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Director of Outlets
  • Belmond Management
  • Santa Barbara, CA FULL_TIME
  • This leadership position is responsible for assisting in the smooth functioning of service for The Dining Room, The Pool, and assisting with other outlets when necessary. Guides a team of skilled line...
  • 6 Days Ago

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Director of Client Accounting
  • Balance Financial Management
  • Santa Barbara, CA FULL_TIME
  • We are a finance management firm, based in Santa Barbara, Calif., focusing on providing a premium service to our clients to create opportunities for greater impact in the world. Our business is about ...
  • 1 Month Ago

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Associate Director, Online Learning & Events Management
  • Pacifica Graduate Institute
  • Santa Barbara, CA FULL_TIME
  • Pacifica Graduate Institute is a WASC accredited graduate school offering a variety of masters and doctoral degree programs framed in the traditions of depth psychology. The Institute has established ...
  • 10 Days Ago

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0 Utilization Management Director jobs found in Santa Barbara, CA area

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Facilities Associate
  • Planmember Financial Corporation
  • Carpinteria, CA
  • As the Facilities Associate, you will have the responsibility of providing services for the company and be proactive wit...
  • 4/18/2024 12:00:00 AM

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Primary Care Pediatrician/associate Program Director
  • Santa Barbara Neighborhood Clinics
  • Goleta, CA
  • SUMMARY: Under the supervision of the Chief Medical Officer, the Primary Care Pediatrician/Associate Program Director is...
  • 4/18/2024 12:00:00 AM

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Director of Development (6 years fundraising experience)
  • New Directions for people with disabilities, inc. (New Directions Travel)
  • Santa Barbara, CA
  • Organization New Directions for People with Disabilities, inc (NEW DIRECTIONS TRAVEL) is a not-for-profit organization b...
  • 4/17/2024 12:00:00 AM

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Executive Director
  • Angels Foster Care of Santa Barbara
  • Santa Barbara, CA
  • About the Position: Angels Foster Care is seeking a dedicated, dynamic, innovative Executive Director who is passionate ...
  • 4/17/2024 12:00:00 AM

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Director of Operations
  • Devereux Advanced Behavioral Health
  • Santa Barbara, CA
  • Company Background Devereux Advanced Behavioral Health (https://www.devereux.org) changes lives – by unlocking and nurtu...
  • 4/16/2024 12:00:00 AM

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Director of Operations
  • Devereux Advanced Behavioral Health
  • Santa Barbara, CA
  • Company Background Devereux Advanced Behavioral Health (https://www.devereux.org) changes lives by unlocking and nurturi...
  • 4/16/2024 12:00:00 AM

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Facilities Associate
  • PlanMember Financial Corporation
  • Carpinteria, CA
  • As the Facilities Associate, you will have the responsibility of providing services for the company and be proactive wit...
  • 4/15/2024 12:00:00 AM

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Director, Customer Service
  • Western Growers
  • Oxnard, CA
  • **Description** Join our team of dedicated professionals who are committed to ensuring our clients can provide affordabl...
  • 4/15/2024 12:00:00 AM

Santa Barbara (Spanish: Santa Bárbara) is the county seat of Santa Barbara County in the U.S. state of California. Situated on a south-facing section of coastline, the longest such section on the West Coast of the United States, the city lies between the steeply rising Santa Ynez Mountains and the Pacific Ocean. Santa Barbara's climate is often described as Mediterranean, and the city has been promoted as the "American Riviera". As of 2014, the city had an estimated population of 91,196, up from 88,410 in 2010, making it the second most populous city in the county after Santa Maria. The contig...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Utilization Management Director jobs
$136,688 to $184,830
Santa Barbara, 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