10 Director of Utilization Management Jobs in Miami, FL
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Regis HR Group is Hiring a Director of Utilization Management Near Miami, FL
Essential Responsibilities:
- Provides overall direction, design, development implementation and monitoring of utilization programs to meet the utilization goals while maintaining customer satisfaction.
- Analyzes root causes for spikes in utilization in Medicare Part A, B and D. Takes data driven approach when formulating utilization management solutions.
- Creates, manages and updates preferred specialist networks focused on cost-effectiveness and high quality.
- Creates, manages and updates, preferred medication/device formulary.
- Develops and implements disease management interventions to lower cost of care.
- Measures and tracks effectiveness of interventions through KPIs, scorecards and CRM system.
- Analyzes and reports significant utilization trends, patterns, and impact to appropriate departmental and medical staff committees.
- Assures compliance with Federal, State, TJC, NCQA, other regulatory agencies and internal standards and requirements.
- Hires, coaches, trains and disciplines staff to ensure smooth operations in utilization management.
- Also facilitates educational training for medical staff on issues related to utilization management.
- Minimum three years of experience in directing utilization management and discharge planning in a clinic setting,
- Strong acumen in analytics - experience with creating, tracking KPIs and measuring ROI of programs,
- Demonstrated interpersonal, negotiation, and leadership skills.
- Effective oral and written communication skills.
- Up to 50% travel to medical centers across Florida
Job Summary
Full Time
Business Services
$115k-150k (estimate)
04/28/2024
05/16/2024
regishrgroup.com
Miami, FL
50 - 100
Business Services
Related Companies
The job skills required for Director of Utilization Management include Case Management, Utilization Management, Coordination, Leadership, Discharge Planning, Written Communication, etc. Having related job skills and expertise will give you an advantage when applying to be a Director of Utilization Management. That makes you unique and can impact how much salary you can get paid. Below are job openings related to skills required by Director of Utilization Management. Select any job title you are interested in and start to search job requirements.
The following is the career advancement route for Director of Utilization Management positions, which can be used as a reference in future career path planning. As a Director of Utilization Management, it can be promoted into senior positions as a Top Clinical Outcomes Executive that are expected to handle more key tasks, people in this role will get a higher salary paid than an ordinary Director of Utilization Management. You can explore the career advancement for a Director of Utilization Management below and select your interested title to get hiring information.
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