Utilization Management Director

Job Description

Job Description

Must Haves :

Bachelors degree in Nursing, Social Work, Mental / Behavioral Health, or a similar healthcare field

5+ years of Clinical experience

State Licensure in healthcare related field- EX : RN, LMSW, LPC, or other applicable licenses.

Plusses :

Masters degree in Nursing or Behavioral Health

Day to Day :

Insight Global is looking for a Director of Uilization Management to sit onsite for a behavioral health system in Erlanger Kentucky. The Director of Utilization Management (UM) is responsible for the oversight of the Utilization Management Department for Inpatient and Outpatient Services. This includes the precertification and recertification process, peer to peer reviews, and appeal. The employee will ensure an appropriate discharge plan is in place for each patient discharge. The employee will accurately report the authorization status of patients, denials and appeals status to the CEO, CFO, and Business Office staff. The Director will ensure all UM staff follow department and facility procedures and ensure effective communication with all relevant departments regarding patient care needs