Director, Utilization Management

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Description

• The Director, Utilization Management 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 assures members receive high quality and appropriate clinical care in a timely and cost-effective manner. • Develop and manage staffing models and operational processes to ensure accurate completion of projects. • Manage department budget and oversee projects that improve efficiency and ensure budgetary and performance goals are met.

Requirements

• Management/supervisory experience, 10 or more years. • 5 years clinical experience in the dental industry is a plus. • Requires research and analytic skills or an ability to oversee, understand, and articulate the results of the research and analysis. • 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 the three pillars of your well-being – mental, physical and financial – including generous vacation and sick time. • Market-leading paid family, parental and adoption leave, a partially-paid sabbatical program. • Medical plans, company paid life and AD&D insurance as well as disability programs and more. • Retirement and Stock Purchase programs to help build and enhance your future financial security including a 401(k) plan with an employer-paid match as well as an employer-funded retirement account. • A flexible work environment with a friendly, caring, collaborative and inclusive culture. • Great Place to Work® Certified in Canada and the U.S. • Named as a “Top 10” employer by the Boston Globe's “Top Places to Work” two years running.