Director-Utilization Management

Direct and manage the day-to-day operations of the Utilization Review department. Position can be worked hybrid or fully remote. This is a full time, exempt position.

ESSENTIAL FUNCTIONS:

• Monitor utilization of services and optimize reimbursement for the facility while maximizing use of the patient’s provider benefits for their needs.
• Conducts and oversees concurrent and retrospective reviews for all patients.
• Act as a liaison between Medicaid reviewers and the staff completing required paperwork to facilitate the Utilization Review process.
• Collaborates with physicians, therapist and nursing staff to provide optimal review based on patient needs.
• Collaborates with ancillary services in order to prevent delays in services.
• Evaluates the UM program for compliance with regulations, policies and procedures.
• May review charts and make necessary recommendations to the physicians, regarding utilization review and specific managed care issues.
• Provide staff management to including hiring, development, training, performance management and communication to ensure effective and efficient department operation.

Benefits Include: (depending on the number of worked)

• Health insurance
• Paid time off
• Dental insurance
• 401(k)
• Vision insurance
• Flexible schedule
• Life insurance
• 401(k) matching
• Employee discount
• Flexible spending account
• Health savings account
• Parental leave
• Employee assistance program

EDUCATION/EXPERIENCE/SKILL REQUIREMENTS:

• Bachelor's Degree in nursing or other clinical field required. Master's Degree in clinical field preferred.
• Six or more year's clinical experience with the population of the facility preferred.
• Four or more years’ experience in utilization management required.   
• Three or more years of supervisory experience required.

Compensation for roles at Montecatini varies depending on a wide array of factors including but not limited to the specific location, role, skill set, and level of experience. As required by local law, Montecatini provides a reasonable hourly range of compensation for roles that may be hired in California as set forth below.

Role Location: California, Remote option available

Calculated Salary Range for role.

California: $83,200 to $93,600