What are the responsibilities and job description for the Senior Director of Utilization Management position at Warren Averett Executive Search & Recruiting?
Warren Averett is assisting a client in the Birmingham area with the search for a Senior Director of Utilization Management to lead and oversee UM processes across a statewide correctional healthcare system. This leadership role is ideal for a licensed Nurse Practitioner (NP) with strong experience in correctional healthcare and a proven track record in utilization management and clinical operations.
Key Responsibilities
- Lead and manage the Utilization Management program across multiple correctional facilities
- Supervise and mentor UM nurses and NPs, ensuring consistency and quality in clinical reviews
- Review and approve specialty referrals, diagnostics, and procedures for medical necessity and cost-effectiveness
- Analyze UM trends and collaborate with clinical leaders to improve efficiency and outcomes
- Serve as the clinical liaison between site teams, corporate leadership, and external partners
- Ensure compliance with NCCHC/ACA standards, contract requirements, and applicable regulations
- Support quality improvement initiatives and reporting efforts
Qualifications
- Licensed Nurse Practitioner (NP) with active, unrestricted license
- Correctional healthcare experience strongly preferred
- Demonstrated expertise in Utilization Management and care coordination
- Proven leadership and team management skills across multiple locations
- Strong communication, analytical, and decision-making abilities
- Familiarity with NCCHC/ACA standards and correctional healthcare regulations
- Willingness to travel as needed
Preferred Qualifications
- Experience leading UM programs at a system-wide level
- Background in quality improvement, risk management, or compliance
- Proficiency with electronic health records and UM platforms
Warren Averett is an equal opportunity employer. We hire, promote and make all other employment decisions without regard to race, color, religion, gender, sexual orientation, national origin, citizenship, genetic information, military service, disability, age, or any other unlawful basis.
