Utilization Management Director jobs in Scranton, 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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Director, Insurance & Risk Management
  • ID Logistics
  • Scranton, PA FULL_TIME
  • Description

    ID Logistics has an immediate need for a Director of Insurance and Risk Management reporting to the General Counsel, US. This is a senior level insurance and risk management position with authority to make decisions on risk management issues affecting the Company. Accountable for achieving strategic objectives, ensuring effective risk management for the organization, and leading and/or directing key risk stakeholders. This person owns the process of identifying, measuring and managing insurable or hazard risks, developing reports and plans, and analyzing risk/insurance problems and defining and/or overseeing the implementation of the risk solutions that help optimize operations. Responsibilities: Responsible for being the company’s subject matter expert for insurance and risk management Proactively identify, assess and evaluate operational and corporate risk exposures Oversee the management of all insurance claims Overall management of broker services, insurance carriers and other third party providers Quantify and gather exposures at corporate and local level Work closely with cross-functional departments to ensure policies and procedures established to mitigate risk in all areas of the business, including litigation, contracting, and warehouse operations Conducts risk assessments, collecting and analyzing documentation, statistics, and reports, and communicates to corporate accounting, finance and executive leadership teams Reviews and assesses risk management policies and protocols; makes recommendations and implements modifications and improvements. Recommends and implements risk management solutions such as insurance, safety and security policies, business continuity plans, or recovery measures. Drafts and presents risk reports and proposals to executive leadership and senior staff. Observe all company safety rules and assist in enforcement as appropriate. Other duties as assigned. Safety of our associates has always been Our #1 priority. We are aggressively responding to COVID-19: Take temperatures with a no-touch thermometer at the start of the shift Increased cleaning routines and periodically deep clean Provide associates with appropriate PPE Maintain an ample supply of antibacterial lotion throughout the building Practice social distancing Expect our associates to maintain cleanliness, social distancing, and use PPE Bachelor’s degree in Risk Management, Finance, or related field required; at least seven years of related experience preferred; or equivalent combination of experience and education. Juris Doctorate with the license to practice law in the U.S. preferred.Exceptional knowledge of the workings of insurance coverage, including procuring coverage for various corporate and warehouseman coverages, understanding policy exclusions, negotiating endorsements and claim management. Thorough understanding of policies and best practices of risk management. Excellent verbal and written communication skills. Excellent mathematical and critical thinking skills. Excellent analytical and problem-solving skills. Excellent organizational skills and attention to detail. Strong supervisory and leadership skills. Proficient with Microsoft Office Suite or related software to prepare reports and policies. Equal Opportunity Employer Minorities/Women/Protected Veterans/Disabled
  • 10 Days Ago

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Emergency Management Deputy Director
  • Wayne County
  • Honesdale, PA FULL_TIME
  • The Wayne County Emergency Management Agency is currently accepting applications for a full-time Deputy Director / Operations & Training. This is an Essential, Non-Exempt position a generous benefits ...
  • 10 Days Ago

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Director of Quality & Incident Management
  • St. Joseph's Center
  • Scranton, PA FULL_TIME
  • St. Joseph's Center, a provider of compassionate care and support to individuals with intellectual disabilities, is looking for a leader who is passionate about quality care to fill the role of Direct...
  • Just Posted

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Regional Director of Business Development
  • Longterm Health Management Services
  • Scranton, PA FULL_TIME
  • REGIONAL DIRECTOR OF BUSINESS DEVELOPMENT The Regional Director of Business Development (RDBD) will accomplish the company's goals and objectives by holding hospital liaisons under their direction acc...
  • 1 Day Ago

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Utilization Review Nurse
  • Berkshire Hathaway GUARD Insurance Companies
  • Wilkes Barre, PA FULL_TIME
  • Overview Utilization Review Nurse Berkshire Hathaway GUARD Insurance Companies, an A Superior rated Insurance company is seeking a Utilization Review Nurse who is interested in joining a company with ...
  • 2 Months Ago

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Operations Director of Practice Management and Patient Outreach
  • RURAL HEALTH CORPORATION OF NEPA
  • Barre, PA FULL_TIME
  • Job Overview:General Description: Reporting directly to the COO The Operations Director of Practice Management and Patient Outreach (OD) operationalizes and streamlines patient services coordinated wi...
  • 1 Day Ago

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0 Utilization Management Director jobs found in Scranton, PA area

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Director, Technical Program Management (Bank Tech) PA
  • Capital One
  • Scranton, PA
  • Locations: VA - Richmond, United States of America, Richmond, VirginiaDirector, Technical Program Management (Bank Tech)...
  • 4/18/2024 12:00:00 AM

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VP, Population Health and Practice Transformation
  • The Wright Center Medical Group
  • Scranton, PA
  • Job Type Full-time Description POSITION SUMMARY In partnership with the Chief Medical & Information Officer (CMIO), serv...
  • 4/18/2024 12:00:00 AM

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Hospice Executive Director
  • Prime Source
  • Scranton, PA
  • Job Description Job Description A national Hospice company is searching for an Executive Director for an office in the S...
  • 4/17/2024 12:00:00 AM

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Director - Product Management
  • The AZEK Company
  • Scranton, PA
  • Director, Product Management - Deck and Accessories The AZEK Company Location: Chicago, IL, Wilmington, OH or Scranton, ...
  • 4/16/2024 12:00:00 AM

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Director, Technical Program Management (Bank Tech)
  • Capital One
  • Scranton, PA
  • Locations: VA - Richmond, United States of America, Richmond, Virginia Director, Technical Program Management (Bank Tech...
  • 4/15/2024 12:00:00 AM

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Director, Technical Program Management - Enterprise Data
  • Capital One
  • Scranton, PA
  • Center 3 (19075), United States of America, McLean, Virginia Director, Technical Program Management - Enterprise Data Ab...
  • 4/15/2024 12:00:00 AM

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Director, Technical Program Management - Card Data Tech
  • Capital One
  • Scranton, PA
  • Center 1 (19052), United States of America, McLean, Virginia Director, Technical Program Management - Card Data Tech Abo...
  • 4/15/2024 12:00:00 AM

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Wait Staff Lead - University of Scranton
  • Aramark
  • Scranton, PA
  • Job Description The Wait Staff Lead position is vital to achieving excellent guest service and executing catering events...
  • 3/22/2024 12:00:00 AM

Scranton is the sixth-largest city in the Commonwealth of Pennsylvania. It is the county seat and largest city of Lackawanna County in Northeastern Pennsylvania's Wyoming Valley and hosts a federal court building for the United States District Court for the Middle District of Pennsylvania. With a population of 77,291, it is the largest city in the Scranton–Wilkes-Barre–Hazleton, PA Metropolitan Statistical Area, which has a population of about 570,000. The city is conventionally divided into 7 districts: North Scranton, Southside, Westside, East Scranton (Hill Section), Central City, Minooka, ...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Utilization Management Director jobs
$119,729 to $161,898
Scranton, 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