Director, Inpatient Um

Point32health Inc

Base: $166,666.40 - $249,999.60; bonus/equity: var...
Fully remote
10+ years managed care operations experience
Commercial, senior, and public plans knowledge
Cms, ncqa, doi regulatory compliance expertise
The Director is responsible for directing business processes and operations for utilization management review to ensure achievement of corporate goals and regulatory compliance

Job Summary

  • The Director is responsible for directing business processes and operations for utilization management review to ensure achievement of corporate goals and regulatory compliance.
  • Point32Health is a leading not-for-profit organization dedicated to delivering high-quality, affordable healthcare to nearly 2 million members.
  • The role offers a competitive total rewards package including medical, dental, vision coverage, retirement plans, and paid time off.

Matching Summary

The Director is responsible for directing business processes and operations for utilization management review to ensure achievement of corporate goals and regulatory compliance.

Salary

Base: $166,666.40 - $249,999.60; Bonus/Equity: Variable pay eligible; Benefits: Comprehensive total rewards including medical, dental, vision, and retirement plans

Skills & Requirements

Must-have

  • 10+ years managed care operations experience
  • Commercial, Senior, and Public Plans knowledge
  • CMS, NCQA, DOI regulatory compliance expertise
  • Inpatient utilization management leadership
  • Staff recruitment and performance evaluation

Nice-to-have

  • Certification in Utilization Management
  • Master's degree in Nursing or related field
  • High energy personality type
  • Strong diplomatic skills for sensitive issues
  • Experience with behavioral health integration

Key Requirements

  • RN with unrestricted MA license preferred
  • Bachelor's degree required; Master's preferred
  • 4+ years at management level
  • Valid drivers' license required
  • Experience with Medicaid and Medicare products

Work Rights

Not specified

Tailored Resume

Cover Letter