Washington State Licensed Director of Utilization Management
A company is looking for a Director of Utilization Management. Key Responsibilities Provide leadership and strategic vision for Utilization, Denial Management, Payer Notification, and Payer Audit processes Implement best practice procedures for provider appeals, payer audit responses, and utilization review in compliance with guidelines Guide the development, organization, planning, and implementation of projects to enhance quality-driven outcomes Required Qualifications Bachelor's Degree in Nursing (BSN), Health Administration, Nutrition, or a business-related field Master's Degree in Business, Public Health, or Healthcare Administration preferred Ten years of nursing experience in an acute care setting, particularly in managed care Five years of utilization management and/or case management experience Current Registered Nurse license in Washington State or Multistate License endorsement (MLS)
A company is looking for a Director of Utilization Management.
Key Responsibilities
Provide leadership and strategic vision for Utilization, Denial Management, Payer Notification, and Payer Audit processes
Implement best practice procedures for provider appeals, payer audit responses, and utilization review in compliance with guidelines
Guide the development, organization, planning, and implementation of projects to enhance quality-driven outcomes
Required Qualifications
Bachelor's Degree in Nursing (BSN), Health Administration, Nutrition, or a business-related field
Master's Degree in Business, Public Health, or Healthcare Administration preferred
Ten years of nursing experience in an acute care setting, particularly in managed care
Five years of utilization management and/or case management experience
Current Registered Nurse license in Washington State or Multistate License endorsement (MLS)
