Utilization Management Director jobs in Nebraska

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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Utilization Management Assistant
  • CHI Health Immanuel
  • OMAHA, NE PART_TIME
  • Overview

    Our Utilization Management Assistant receives, processes, facilitates and documents all payer communications.  This position supports denial mitigation by sending documentation within the contracted time period, following up on accounts lacking authorization and communicating with internal stakeholders to ensure the accurate submission of clinical documentation to third party payers.  


    Responsibilities
    • Receives, sends and documents payer requests for clinical documentation.
    • Receives and documents payer authorization and communications including but not limited to concurrent denials.
    • Coordination of peer to peer conversations, as applicable.
    • Reviews surgery schedule to verify correct authorization is documented, if applicable.
    • Identifies accounts lacking authorization and follows up with payers, as needed.
    • Communicates with interdepartmental staff regarding payer documentation requests.
    • Under RN direction submits requests for and follows up on administrative days authorization, where indicated.
    • Identifies and reports trends to department Leadership.
    • Utilizes payer related reports from Care Management software, where applicable.
    • Collaborates with and supports the UM team including but not limited to UR and Denials RN.
    • Contributes to the identification of opportunities for process improvement.
    • Supports administrative departmental functions, as assigned.
    • Other job duties as assigned.

    Qualifications

    Required Education and Experience

    Required

    ●        Minimum one year experience in a hospital, physician’s office, or medical group performing duties related to admitting, business office, payer communications or managed care or an equivalent combination of education and experience

    ●        High school diploma or GED required

    Preferred

    ●        An understanding of operations and functions of care coordination, utilization management, denials mitigation is preferred.

  • 1 Day Ago

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Director of Digital Product Management
  • Arrow Electronics
  • Nebraska, NE FULL_TIME
  • Description Arrow Electronics is a global provider of products, services, and solutions to industrial and commercial users of electronic components and enterprise computing solutions. Arrow Electronic...
  • 1 Day Ago

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Director, Treasury Management (AgriBusiness)
  • First National Bank of Omaha
  • Omaha, NE FULL_TIME
  • At FNBO, our employees are the heart of our story-and we're committed to their success! Please see below the details of this career opportunity and how it fits into our organization's success.Our Mode...
  • 1 Day Ago

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Director of Operations Property Management
  • NEBRASKA LIFESTYLES LLC
  • Omaha, NE FULL_TIME
  • Must have extensive experience in Property Management at a high level. Regional Managers or Operations Managers are encouraged to apply.We are a fast-growing property management company specializing i...
  • 2 Days Ago

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Director-Product Management-Remote
  • Moody's Career
  • Omaha, NE FULL_TIME
  • We are seeking a dynamic and experienced Director of Product Management to lead the strategic direction and development of our loan portfolio management solution. The successful candidate will leverag...
  • 15 Days Ago

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Director of Marketing
  • Weitz Investment Management
  • Omaha, NE FULL_TIME
  • About the Position Reporting to and working closely with the Chief Client Officer (CCO), the Director of Marketing (DOM) will support the CCO in leading Weitz Investment Management's (WIM) marketing s...
  • 24 Days Ago

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Managing Director, Practice Management - Private Equity
  • Goodwin Procter LLP
  • Boston, MA
  • Make an impact at Goodwin, where we partner with our clients to practice law with integrity, ingenuity, agility and ambi...
  • 3/29/2024 12:00:00 AM

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Operational Risk Management Director -- Issues Management
  • MUFG (DBA)
  • New York, NY
  • Do you want your voice heard and your actions to count? Discover your opportunity with Mitsubishi UFJ Financial Group (M...
  • 3/29/2024 12:00:00 AM

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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

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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

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Managing Director, Product Management
  • Omnicom Media Group
  • New York, NY
  • Overview Job Description Annalect's 2,000+ innovators leverage data and technology to help clients across Omnicom build ...
  • 3/27/2024 12:00:00 AM

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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

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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

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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

The state is bordered by South Dakota to the north; Iowa to the east and Missouri to the southeast, across the Missouri River; Kansas to the south; Colorado to the southwest; and Wyoming to the west. The state has 93 counties and is split between two time zones, with the state's eastern half observing Central Time and the western half observing Mountain Time. Three rivers cross the state from west to east. The Platte River, formed by the confluence of the North Platte and the South Platte, runs through the state's central portion, the Niobrara River flows through the northern part, and the Rep...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Utilization Management Director jobs
$118,498 to $160,230

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