Director, Inpatient Um

Point32health Inc

Canton, MA, United States
Base: $166,666.40 - $249,999.60; bonus/equity: not...
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Utilization management review
Medical management activities
Regulatory compliance
** Point32Health Inc. is seeking a Director of Inpatient Utilization Management to oversee utilization management processes and ensure compliance with healthcare regulations. The ideal candidate will possess extensive experience in managed care, strong leadership skills, and a commitment to improving healthcare outcomes for their members. **

Job Summary

  • The Director, Inpatient Utilization Management is responsible for directing, leading, and modifying the business processes and operations for utilization management (UM) review.
  • The Director oversees and leads medical management activities related to utilization management and discharge planning for acute inpatient, LTAC (Long-term Acute Care) rehabilitation and skilled nursing services.
  • Point32Health offers their Colleagues a competitive and comprehensive total rewards package which currently includes medical, dental and vision coverage, retirement plans, and paid time off.

Matching Summary

Match Score: 75

** Point32Health Inc. is seeking a Director of Inpatient Utilization Management to oversee utilization management processes and ensure compliance with healthcare regulations. The ideal candidate will possess extensive experience in managed care, strong leadership skills, and a commitment to improving healthcare outcomes for their members. **

Salary

Base: $166,666.40 - $249,999.60; Bonus/Equity: Not specified; Benefits: Medical, dental, vision, retirement, PTO, life/disability insurance, tuition program, well-being benefits

Skills & Requirements

Must-have

  • utilization management review
  • medical management activities
  • regulatory compliance
  • strategic development and deployment
  • collaboration with leadership
  • budget management

Nice-to-have

  • high energy personality
  • process engineering and improvement
  • systems thinking
  • influencing others
  • change management skills

Key Requirements

  • RN with unrestricted MA license preferred
  • 10+ years progressive operations experience in managed care
  • 4+ years management level experience
  • Experience with commercial, exchange, Medicaid and Medicare products
  • Managed care systems experience
  • Bachelor's degree required

Work Rights

Not specified

Tailored Resume

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