Utilization Management Director jobs in Toledo, OH

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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Admissions Director
  • Ciena Healthcare Management
  • Temperance, MI FULL_TIME
  • Do you have a background in healthcare sales and marketing? If you enjoy working with seniors and their families to secure the best care for a post-acute stay, consider the role of Admissions Coordinator at Hickory Ridge of Temperance!

    The Admissions Coordinator manages the facility’s census by developing and maintaining positive relationships with hospitals, physician groups, community organizations and insurers.

    At Ciena Healthcare, we take care of you too, with an attractive benefit package including:

    • Competitive pay,

    • Life Insurance,

    • 401K with matching funds,

    • Health insurance,

    • AFLAC.

    • Employee discounts

    • Tuition Reimbursement

    • SPOTLIGHT, our virtual community and rewards and recognitions program, exclusively for Ciena staff members

    In addition, we will help you advance your career with tuition reimbursement, discounts and other support.

    You will join an experienced, hard-working team that values communication and strong teamwork abilities.

    Responsibilities

    • Act as a liaison between the facility and the outside community.

    • Connect daily with potential referral sources including hospitals, physicians, insurers, case management companies and health care agencies.

    • Create and execute facility sales and marketing plans and strategies.

    • Conduct facility tours for potential guests and families.

    • Conduct admission screenings of potential guests; determine level of care, services required, equipment needs and insurance coverage as needed.

    • Welcome guests and family upon admission.

    Qualifications

    • Bachelor’s degree

    • Experience in healthcare sales, marketing, insurance or commensurate education preferred.

    • Experience in managed care or insurance preferred.

    • Active Michigan LPN License preferred
    • .

    About Ciena Healthcare

    Ciena Healthcare is Michigan’s largest provider of skilled nursing and rehabilitation care services.

    We serve our residents with compassion, concern, and excellence, believing that every one of them is a unique person who deserves our best each day that we care for them. If you have a passion for improving the lives of those around you and working with others who feel the same way, Ciena is the place for you!

    #SPONSOR

  • 2 Months Ago

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Regional Director of Nursing
  • Lionstone Care Management
  • Toledo, OH FULL_TIME
  • Competitive compensation with generous benefits package! Warm and supportive team! At Lionstone Care Management, we’re raising the bar on skilled nursing and assisted living care. Discover what sets o...
  • 2 Days Ago

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Physician - Medical Director
  • Sophia Medical Management
  • Toledo, OH FULL_TIME
  • Clinic Medical Director Qualifications: 3 years' experience in ANY of the following: Family Practice Occupational Medicine Internal Medicine Emergency Department (ED) Valid Medical Doctor (MD) in the ...
  • 30 Days Ago

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Director of Social Services
  • Ciena Healthcare Management
  • Monroe, MI FULL_TIME
  • Are you a social worker dedicated to improving the lives of seniors? As the Director of Social Services at Ciena Healthcare you will provide medically-related social services that help guests to attai...
  • 1 Month Ago

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Director of Social Services
  • Ciena Healthcare Management
  • Temperance, MI FULL_TIME
  • Are you a social worker dedicated to improving the lives of seniors? As the Director of Social Services at Ciena Healthcare you will provide medically-related social services that help guests to attai...
  • 2 Months Ago

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Utilization Review & Credentialing Specialist
  • ZEPF CENTER
  • Toledo, OH FULL_TIME
  • Description Zepf Center has been serving the Lucas County community for nearly 50 years. We are the leading provider of behavioral health and substance use disorder services in Northwest Ohio. Service...
  • 6 Days Ago

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0 Utilization Management Director jobs found in Toledo, OH area

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Director of Mission Integration & Chaplain
  • CHI Living Communities
  • Toledo, OH
  • Franciscan Care Center has an exciting new opportunity for a Director of Mission Integration & Chaplain. Franciscan Care...
  • 4/19/2024 12:00:00 AM

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RN / Registered Nurse - Patient Care Supervisor - Obstetrics - Full Time - Days
  • Promedica
  • Martin, OH
  • ProMedica Monroe Regional Hospital offers a broad range of inpatient and outpatient services in southern Michigan and Oh...
  • 4/19/2024 12:00:00 AM

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Program Leader- Part-Time
  • AFTER-SCHOOL ALL-STARS OHIO
  • Toledo, OH
  • ASAS is currently seeking exceptional and engaging youth leaders to assist in providing leadership and support in academ...
  • 4/17/2024 12:00:00 AM

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Hydraulics Department Head
  • Brick Staffing, LLC
  • Toledo, OH
  • Job Description Job Description Position: Hydraulic Department Head Job Summary: Responsible for department performance ...
  • 4/16/2024 12:00:00 AM

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Director of Financial Planning and Analysis
  • The University Of Toledo Foundation
  • Toledo, OH
  • PRIMARY RESPONSIBILITY: The Director of Financial Planning & Analysis will play a pivotal role in driving financial perf...
  • 4/16/2024 12:00:00 AM

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Server Assistant/Busser/Host
  • Red Lobster
  • Maumee, OH
  • Job Overview Are you looking to work with the best in the industry to enhance your hospitality career? As a Service Assi...
  • 4/15/2024 12:00:00 AM

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Pharmacy Team Lead - Pharmacy Services - Paramount - Full Time - Days
  • Promedica
  • Toledo, OH
  • Paramount Health Care, a ProMedica Health Plan, offers insurance products across six Midwest states. This Ohio-based com...
  • 4/15/2024 12:00:00 AM

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Director of Financial Planning and Analysis
  • The University of Toledo Foundation
  • Toledo, OH
  • PRIMARY RESPONSIBILITY: The Director of Financial Planning & Analysis will play a pivotal role in driving financial perf...
  • 4/15/2024 12:00:00 AM

Toledo (/təˈliːdoʊ/) is a city in and the county seat of Lucas County, Ohio, United States. Toledo is in northwest Ohio, at the western end of Lake Erie bordering the state of Michigan. The city was founded in 1833 on the west bank of the Maumee River, and originally incorporated as part of Monroe County, Michigan Territory. It was re-founded in 1837, after conclusion of the Toledo War, when it was incorporated in Ohio. After the 1845 completion of the Miami and Erie Canal, Toledo grew quickly; it also benefited from its position on the railway line between New York City and Chicago. The first...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Utilization Management Director jobs
$122,260 to $165,320
Toledo, Ohio area prices
were up 1.3% 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