Utilization Management Director jobs in Alabama

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)

J
Assistant Director Case Management & Utilization Review
  • JACKSON HOSPITAL AND CLINIC
  • Montgomery, AL FULL_TIME
    • Support the Case Management Director and Utilization Review Program
    • Monitors patient results, optimizing resource distribution and implementing continuing care plans to meet patients' post-discharge needs
    • Utilizes chart review, electronic medical record, patient/family interviews, along with the medical group data
    • Organizes plans and prioritizes caseload to optimize care coordination; prioritizes case management for individuals with higher risk factors
    • Evaluates discharge planning needs on admission inspection
    • Collaborates with patient/family, physicians, nurses, ancillary personnel and external agencies to develop safe, individualized, and appropriate continuing care plans
    • Support Director in management a staff of 10-25 case managers and Utilization Review team members
    • Support Director in Hiring, supervise and evaluate case management staff.  Supervise a case management staff with diverse areas of expertise including job development;
    •  Work collaboratively with Intake and Outreach staff, Director of Programs to meet program goals and performance targets.
    •  Analyze program data and plan for program improvements;
    • With support from Director of Programs, submit monthly reports with quantitative and qualitative information with support from Case management Director.
    • Review/Audit of client files to ensure case management plans address identified needs, are up-to-date and that data quality is maintained;
    • Ensure case management staff are regularly monitoring client activity related to achieving personal and programmatic goals, and providing corrective action revisions to case plans as needed
    • Coordinate staff and scheduling and case management assignments;
    • Attend program-related community, coalition and committee meetings
    • Conduct or arrange for appropriate orientations, in-services, and training for program staff
    • Mediate client grievances and facilitate case management/client issues
    • Ensure that Case Managers continually monitor and evaluate each client’s progression through their case management plan, developing corrective action revisions to the plan as needed.
    •  Assist clients in obtaining necessary resources to achieve case management goals;
    • Actively participate in client- and program-related meetings and trainings
    • Attend program-related community, coalition and committee meetings as assigned;
    • Maintain client related data systems, including case notes
    • Prepare case management related reports including but not limited to: outcomes, successes, etc;
    • Adheres to strict boundaries and professional ethics in the care of others;  Conducts crisis intervention as needed
    • Other requirements or duties as assigned
    • Data Analytics
    • Creating and evaluating reports
    • Use of data analytics software
  • 9 Days Ago

B
Utilization Management Nurse
  • Blue Eagle Consulting
  • Birmingham, AL FULL_TIME
  • Blue Eagle is looking for Pre-Cert Nurse(s) to assist with inpatient and outpatient PA reviews.
  • 10 Days Ago

U
UTILIZATION MANAGEMENT COORDINATOR
  • Universal Health Services, Inc.
  • Birmingham, AL FULL_TIME
  • ResponsibilitiesUtilization Management (UM) Coordinator- PRN Hill Crest Behavioral Health is an acute care, 194 bed inpatient psychiatric facility located in Birmingham, AL, providing mental health se...
  • 1 Month Ago

H
RN - Weekend Utilization Management (Fri-Sun 7a-7p)
  • Humana
  • UNKNOWN, AL FULL_TIME
  • Become a part of our caring community and help us put health first The Utilization Management Nurse 2 utilizes clinical nursing skills to support the coordination, documentation and communication of m...
  • 3 Days Ago

S
Asset Manager/Director, Asset Management
  • Southeastern Property Management, LLC
  • Birmingham, AL FULL_TIME
  • SUMMARYSPM manages nearly 200 communities across the country with divisions specializing in Conventional, Student, Affordable, and Senior. The SPM brand has been in business for nearly 50 years and ha...
  • 25 Days Ago

U
Registered Nurse (RN) - Utilization Review - Care Management- University Hospital
  • USA Health Systems
  • Mobile, AL FULL_TIME
  • Overview USA Health is Transforming Medicine along the Gulf Coast to care for the unique needs of our community. USA Health is changing how medical care, education and research impact the health of pe...
  • 23 Days Ago

S
Managing Director
  • SpartaCraft
  • Connelly Springs, NC
  • Job Description Job Description SpartaCraft, a contract wood products and finishing company in Connelly Springs, NC is l...
  • 3/28/2024 12:00:00 AM

C
Health Information Management Director
  • Clinical Management Consultants
  • Waterflow, NM
  • Calling all Health Information Management professionals looking to advance their career by joining an award winning hosp...
  • 3/28/2024 12:00:00 AM

C
Case Management Director
  • Clinical Management Consultants
  • Plainview, TX
  • An award winning medical center is searching for a strong, experienced Case Management Director. Our team is excited to ...
  • 3/25/2024 12:00:00 AM

O
Managing Director / Senior Managing Director - Debt Advisory
  • Oberon Securities, LLC
  • New York, NY
  • Oberon Securities, based in New York City, is seeking experienced Managing Directors with expertise raising asset, cash ...
  • 3/25/2024 12:00:00 AM

F
Managing Director Relationship Manager-MMB
  • First Citizens Bank
  • Santa Monica, CA
  • Overview: First Citizens Middle Market Banking delivers a range of financial solutions to midsize clients through a rela...
  • 3/25/2024 12:00:00 AM

T
Managing Director
  • Transamerica Premier Life Insurance Company
  • Nashville, TN
  • The Managing Director is responsible for growing the business of the District Office by developing new quality sales, co...
  • 3/25/2024 12:00:00 AM

A
Managing Director
  • Artech L.L.C.
  • Fremont, CA
  • Artech is currently looking to hire an experienced Managing Director to join our expanding team in Fremont, CA (Hybrid)....
  • 3/25/2024 12:00:00 AM

S
Managing Director
  • Selby Jennings
  • Chicago, IL
  • Join a dynamic and growing team at our Client; A premier financial services firm specializing in middle-market transacti...
  • 3/24/2024 12:00:00 AM

Alabama (/ˌæləˈbæmə/) is a state in the southeastern region of the United States. It is bordered by Tennessee to the north, Georgia to the east, Florida and the Gulf of Mexico to the south, and Mississippi to the west. Alabama is the 30th largest by area and the 24th-most populous of the U.S. states. With a total of 1,500 miles (2,400 km) of inland waterways, Alabama has among the most of any state. Alabama is nicknamed the Yellowhammer State, after the state bird. Alabama is also known as the "Heart of Dixie" and the "Cotton State". The state tree is the longleaf pine, and the state flower is...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Utilization Management Director jobs
$116,022 to $156,883

Utilization Management Director in Abilene, TX
With an ever-increasing emphasis on reducing costs while still improving patient outcomes, utilization management is taking on new importance.
February 09, 2020
Utilization Management Director in Las Vegas, NV
Read more about the Humana Behavioral Health utilization management process and how it determines patient care.
February 18, 2020
Utilization Management Director in Boise, ID
Provides thought leadership on utilization initiatives and activities to enhance interdepartmental coordination.
December 19, 2019