Director - Utilization Management
8 hours ago
Description
• The Director participates in the design, strategic planning, development, implementation, and administration of all aspects of the utilization management programs. • The position maintains delivery of a high value utilization management program and for assuring members receive high quality clinical care. • Responsible for developing strong cost and quality oversight procedures with vendors or partners. • Ensures that systems and processes demonstrate the value and effectiveness of utilization management programs.
Requirements
• Management/supervisory experience, 10 or more years. • 5 years clinical experience in the dental industry is a plus. • Requires research and analytic skills. • Knowledge and understanding of regulatory language. • Excellent oral and written communications skills. • Experience managing cross functional projects. • Knowledge of managed care health plans operations and HIPAA guidelines. • Experience and knowledge in intermediate computer skills.
Benefits
• Excellent benefits and wellness programs to support mental, physical and financial well-being. • Generous vacation and sick time, market-leading paid family, parental and adoption leave. • Partially-paid sabbatical program, medical plans. • Company paid life and AD&D insurance and disability programs. • Retirement and Stock Purchase programs including a 401(k) plan with an employer-paid match.
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