Utilization Management Director jobs in Tuscaloosa, AL

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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Case Management Director II
  • Encompass Health
  • Whitewood, CA FULL_TIME
  • Salary Range: $115k - $130k

    As a member of Senior Leadership, the Director of Case Management (DCM) is responsible for the day to day operations and human resource management of the department of Case Management. With a central focus on census management, patient care outcomes, and key care indicators, the DCM oversees the interdisciplinary plan of care and the discharge planning process to ensure the effectiveness and appropriateness of services. The DCM is a patient and family advocate to ensure that services are delivered to meet the needs of patients and their families, and that the utilization of resources is appropriate.



    RESPONSIBILITIES AND TASKS

    Performs all duties and responsibilities of a Case Manager during case management services.

    Assigns patient caseload to department members and self for optimal service delivery.

    Coordinates/communicates effectively with administration, medical staff, and interdisciplinary team.

    Participates, as appropriate, in developing managed care strategies and plans for the hospital.

    Consults on service delivery, financial management, and discharge planning processes.

    Oversees team conference process and educates staff in facilitation and reporting.

    Leads daily case management operations meetings.

    Represents department in hospital operations.

    Analyzes reports from systems such as PATCOM, UDS, and Press Ganey.

    Implements- and educates case managers on- effective continuum of care and community resources.

    Provides appropriate training, education, and management to the department of Case Management.

    Trains Case Managers on managing caseloads and interpreting regulations, policies, operational procedures and objectives.

    Reviews operations in assigned area to ensure a high level of quality that is consistent with organizational standards.

    Completes special projects and other duties as requested to support needs of organization.

    Coordinates and participates in hospital utilization review process.

    Performs case management analysis.

    Oversees concurrent review functions with appropriate follow-up action plan and intervention.

    Ensures compliance with CMS regulations and Conditions of Participations for discharge planning.

    Manages core staffing plan and employs flexible staffing plan as necessary.

    Builds relationships as defined through targeted goals of the business plan.

    Networks with insurance companies, self-insured employers, case management firms, and/or other health care networks.

    Acts as a resource for case managers and other team members.

    Coordinates with other department managers to direct quality of care delivery.

    Completes mandatory training and courses required by completion date.

    Participates in administrative on-call schedule and coordinates case management on-call schedule.

    Qualifications

    License or Certification:

    Must be qualified to independently complete an assessment within the scope of practice of his/her discipline (for example, RN, SW, OT, PT, ST, and Rehabilitation Counseling).

    If licensure is available for the discipline within the hospital's state, individual must hold an active license.

    Current CCM® or ACM certification is required or must have obtained within one year of being placed in the position.

    Minimum Qualifications:

    For Nursing, must possess bachelor's degree in Nursing (BSN) with RN licensure.

    For other eligible health care professionals, must possess a minimum of a bachelor's degree; graduate degree is preferred.

    3 years of hospital-based Case Management experience including Utilization Review and Discharge Planning experience.

    ABOUT US

    As a national leader in post-acute care, Encompass Health (NYSE: EHC) offers facility-based patient care through its network of inpatient rehabilitation hospitals. With a national footprint that spans 157 hospitals in 37 states and Puerto Rico, the Company is committed to delivering high-quality, cost-effective rehabilitation. Encompass Health is ranked as one of Fortune's 100 Best Companies to Work For and Modern Healthcare's Best Places to Work.



    BENEFITS

    Enjoy competitive compensation and benefits that start day one of employment, including:

    • Affordable medical, dental and vision plans provided to meet the needs of full and part-time employees and their families.
    • Generous paid time off that increases with tenure.
    • Tuition reimbursement and continuing education opportunities.
    • An employee assistance program for counseling and mental health needs.
    • Company-matching 401(k) and employee stock-purchase plans.
    • Flexible spending and health savings accounts.


    To learn more about us, please visit us online at encompasshealth.com or careers.encompasshealth.com



    Connect with us:

    https://www.facebook.com/EncompassCareers

    https://www.linkedin.com/company/encompasshealth/

    https://twitter.com/encompasshlth

    https://www.glassdoor.com/Overview/Working-at-Encompass-Health-EI_IE1959649.11,27.htm





    Equal Opportunity Employer
  • 19 Days Ago

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Environmental Service Director **UNDER NEW MANAGEMENT
  • Arabella Health & Wellness of Butler
  • Butler, AL FULL_TIME
  • Arabella Health & Wellness of Butler is seeking an experienced, dedicated, reliable, Environmental Services Director to oversee the care and cleaning of our healthcare facility. We offer excellent wag...
  • 24 Days Ago

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Director of Project Management (Construction - Architectural Millwork)
  • Impact Solutions Inc
  • Tuscaloosa, AL FULL_TIME
  • Our client is an Alabama-based architectural woodwork contractor, one of the largest architectural millwork companies in the Southeast. They frequently work on impressive, high-quality and high profil...
  • 1 Month Ago

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Dietary Aide **UNDER NEW MANAGEMENT
  • Arabella Healthcare Management
  • Butler, AL FULL_TIME
  • Arabella Health and Wellness of Butler is looking for Dietary Aides to join our team of caring professionals! Do you want to work where you can build meaningful and lasting relationships with resident...
  • 24 Days Ago

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Certified Dietary Manager (CDM) **UNDER NEW MANAGEMENT
  • Arabella Healthcare Management
  • Butler, AL FULL_TIME
  • Arabella Health & Wellness of Butler, is looking for a dynamic, creative, quality-focused Dietary Manager focused on customer service for our long-term care facility dietary program. The candidate mus...
  • 27 Days Ago

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Human Resources/Payroll Manager **UNDER NEW MANAGEMENT
  • Arabella Healthcare Management
  • Butler, AL FULL_TIME
  • Arabella Health & Wellness of Butler, is seeking a qualified Human Resources/Payroll Manager. The Human Resources/ Payroll Manager in long term care serves in a vital role in the overall success of a ...
  • 27 Days Ago

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0 Utilization Management Director jobs found in Tuscaloosa, AL area

Tuscaloosa (/tʌskəˈluːsə/ TUS-kə-LOO-sə) is a city in and the seat of Tuscaloosa County in west central Alabama (in the southeastern United States). Located on the Black Warrior River at the Atlantic Seaboard fall line of the Piedmont, it is the fifth-largest city in Alabama, with an estimated population of 100,287 in 2017. The city was originally known as Tuskaloosa until the early 20th century. Incorporated as a town on December 13, 1819, it was named after Tuskaloosa, the chief of a band of Muskogean-speaking people. They battled and were defeated by forces of Spanish explorer Hernando de S...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Utilization Management Director jobs
$118,590 to $160,357
Tuscaloosa, Alabama 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