Utilization Management Director jobs in Oklahoma

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 Administration Coordinator
  • Humana
  • Tulsa, OK FULL_TIME
  • Become a part of our caring community and help us put health first
     

    The Utilization Management (UM) Coordinator contributes to administration of UM. The UM Coordinator performs varied activities and moderately complex administrative, operational, and Enrollee support assignments. The individual in this role performs computations and typically works on semi-routine assignments.

    RESPONSIBILITIES:

    · Provides nonclinical support for the policies and procedures, ensuring best and most appropriate treatment, care, or services for our Enrollees

    · Assists Providers with discharge planning for Enrollees with inpatient stay or outpatient physical health

    · Works on special projects with the clinical team

    · Completes Provider-facing responsibilities


    Use your skills to make an impact
     

    REQUIRED QUALIFICATIONS:

    - High school diploma or equivalent

    - 1 yr of experience in a healthcare environment.

    - Knowledgeable with behavioral health resources in Oklahoma

    - Proficient using electronic health record and documentation programs

    - Proficient or Intermediate experience with medical terminology or ICD-10 codes

    PREFERRED QUALIFICATIONS:

    - Experience with enrollee services or customer service

    - Associate or bachelor's degree in healthcare, business, finance, or related field

    - Experience working in Medicaid or Medicare

    Work at Home/Hybrid Guidance:
    To ensure Home or Hybrid Home/Office associates’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office associates must meet the following criteria:

    At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is recommended; wireless, wired cable or DSL connection is suggested
    Satellite, cellular and microwave connection can be used only if approved by leadership. Associates who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense. Humana will provide Home or Hybrid Home/Office associates with telephone equipment appropriate to meet the business requirements for their position/job. Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information

    Scheduled Weekly Hours

    40

    Pay Range

    The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.


     

    $37,200 - $51,200 per year


     

    Description of Benefits

    Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.


    About us
     

    Humana Inc. (NYSE: HUM) is committed to putting health first – for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health – delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large.


    Equal Opportunity Employer

    It is the policy of  Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or because he or she is a protected veteran. It is also the policy of  Humana to take affirmative action to employ and to advance in employment, all persons regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.

  • Just Posted

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Registered Nurse - Utilization Management
  • ERP International
  • Tinker AFB, OK OTHER
  • Overview ERP International, LLC is seeking a Registered Nurse - Utilization Managment for a full-time position supporting Medical Managment in support of Tinker AFB, OK. Be the Best! Join our team of ...
  • 5 Days Ago

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Utilization Management RN - Physical Health, OKLAHOMA REMOTE
  • Humana
  • Tulsa, OK FULL_TIME
  • Become a part of our caring community and help us put health first Why Humana?At Humana, caring is everything. You look after our members and patients. We look after you. If caring means something to ...
  • Just Posted

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RN - Weekend Utilization Management (Fri-Sun 7a-7p)
  • Humana
  • UNKNOWN, OK 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...
  • 1 Month Ago

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Case Management Director
  • Clinical Management Consultants
  • Cache, OK FULL_TIME
  • A rewarding opportunity is available to an experienced Case Management Director in Southern Oklahoma! This outstanding team is actively seeking this person to join their highly regarded healthcare org...
  • 21 Days Ago

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Director of Care Management
  • Clinical Management Consultants
  • Norman, OK FULL_TIME
  • A new and exciting opportunity for a Director of Care Coordination has just become available at a 200 bed, highly awarded hospital in Southern Oklahoma! Come join a leading healthcare organization com...
  • 1 Month Ago

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Utility Management Director
  • Hunt
  • Honolulu, HI
  • A Brief Overview The Utility Management Director is responsible for providing leadership, direction and guidance as it p...
  • 4/26/2024 12:00:00 AM

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Facilities Management Director
  • Encompass Health
  • Altoona, PA
  • The Facilities Management Director is responsible for ensuring that the company Rehabilitation Hospital, satellite clini...
  • 4/25/2024 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 ...
  • 4/25/2024 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 ...
  • 4/24/2024 12:00:00 AM

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Utility Management Director
  • Hunt Mh Shared Services Llc
  • Tulsa, OK
  • Hunt MH Shared Services LLC Utility Management Director Seattle , Washington Apply Now DescriptionA Brief OverviewThe Ut...
  • 4/24/2024 12:00:00 AM

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Facilities Management Director
  • Encompass Health
  • Mcdonough, GA
  • The Facilities Management Director is responsible for ensuring that the company Rehabilitation Hospital, satellite clini...
  • 4/23/2024 12:00:00 AM

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Risk Management Director - Asset Management
  • Principal Financial Services Inc.
  • Des Moines, IA
  • What You'll DoWere looking for a Risk Management Director to join our Principal Asset Management team. In this role, you...
  • 4/23/2024 12:00:00 AM

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Facilities Management Director
  • Encompass Health
  • Pleasant Gap, PA
  • The Facilities Management Director is responsible for ensuring that the company Rehabilitation Hospital, satellite clini...
  • 4/22/2024 12:00:00 AM

Oklahoma is the 20th-largest state in the United States, covering an area of 69,899 square miles (181,040 km2), with 68,595 square miles (177,660 km2) of land and 1,304 square miles (3,380 km2) of water. It lies partly in the Great Plains near the geographical center of the 48 contiguous states. It is bounded on the east by Arkansas and Missouri, on the north by Kansas, on the northwest by Colorado, on the far west by New Mexico, and on the south and near-west by Texas. Much of its border with Texas lies along the Southern Oklahoma Aulacogen, a failed continental rift. The geologic figure defi...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Utilization Management Director jobs
$117,071 to $158,304

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