As the Director of Utilization Review , you will play a critical leadership role in ensuring the delivery of high-quality, medically necessary behavioral healthcare while optimizing patient outcomes ...
As the Director of Utilization Review , you will play a critical leadership role in ensuring the delivery of high-quality, medically necessary behavioral healthcare while optimizing patient outcomes ...
As the Director of Utilization Review , you will play a critical leadership role in ensuring the delivery of high-quality, medically necessary behavioral healthcare while optimizing patient outcomes ...
As the Director of Utilization Review , you will play a critical leadership role in ensuring the delivery of high-quality, medically necessary behavioral healthcare while optimizing patient outcomes ...
Direct and manage the day-to-day operations of the Utilization Review department. Responsibilities ESSENTIAL FUNCTIONS: * Monitor utilization of services and optimize reimbursement for the facility ...
Direct and manage the day-to-day operations of the Utilization Review department. Responsibilities ESSENTIAL FUNCTIONS: * Monitor utilization of services and optimize reimbursement for the facility ...
The Utilization Manager is responsible for directing and overseeing the Utilization Program for ... reviewers, and other payors. More information is available on our Benefits Guest Website: benefits ...
The Utilization Manager is responsible for directing and overseeing the Utilization Program for ... reviewers, and other payors. More information is available on our Benefits Guest Website: benefits ...
$90 - $115/hr
Position Description The Utilization Manager is responsible for directing and overseeing the ... reviewers, and other payors. More information is available on our Benefits Guest Website: benefits ...
New
$90 - $115/hr
Position Description The Utilization Manager is responsible for directing and overseeing the ... reviewers, and other payors. More information is available on our Benefits Guest Website: benefits ...
New
The Utilization Manager is responsible for directing and overseeing the Utilization Program for ... reviewers, and other payors. More information is available on our Benefits Guest Website: benefits ...
The Utilization Manager is responsible for directing and overseeing the Utilization Program for ... reviewers, and other payors. More information is available on our Benefits Guest Website: benefits ...
The Utilization Manager is responsible for directing and overseeing the Utilization Program for ... reviewers, and other payors. More information is available on our Benefits Guest Website: benefits ...
The Utilization Manager is responsible for directing and overseeing the Utilization Program for ... reviewers, and other payors. More information is available on our Benefits Guest Website: benefits ...
Cedar Creek Hospital Description The Manager of Utilization Review is responsible for managing and ... 5 years direct clinical experience in a psychiatric or mental health treatment setting. EEO ...
Cedar Creek Hospital Description The Manager of Utilization Review is responsible for managing and ... 5 years direct clinical experience in a psychiatric or mental health treatment setting. EEO ...
Cedar Creek Hospital Description The Manager of Utilization Review is responsible for managing and ... Requirements LMSW, LPC, RN or LVN licensure in the state of Michigan required. 3-5 years direct ...
New
Cedar Creek Hospital Description The Manager of Utilization Review is responsible for managing and ... Requirements LMSW, LPC, RN or LVN licensure in the state of Michigan required. 3-5 years direct ...
New
Cedar Creek Hospital Description The Manager of Utilization Review is responsible for managing and ... Requirements LMSW, LPC, RN or LVN licensure in the state of Michigan required. 3-5 years direct ...
New
Cedar Creek Hospital Description The Manager of Utilization Review is responsible for managing and ... Requirements LMSW, LPC, RN or LVN licensure in the state of Michigan required. 3-5 years direct ...
New
Cedar Creek Hospital Description The Manager of Utilization Review is responsible for managing and ... Requirements LMSW, LPC, RN or LVN licensure in the state of Michigan required. 3-5 years direct ...
New
Cedar Creek Hospital Description The Manager of Utilization Review is responsible for managing and ... Requirements LMSW, LPC, RN or LVN licensure in the state of Michigan required. 3-5 years direct ...
New
Cedar Creek Hospital Description The Manager of Utilization Review is responsible for managing and ... Requirements LMSW, LPC, RN or LVN licensure in the state of Michigan required. 3-5 years direct ...
New
Cedar Creek Hospital Description The Manager of Utilization Review is responsible for managing and ... Requirements LMSW, LPC, RN or LVN licensure in the state of Michigan required. 3-5 years direct ...
New
Day Shift Description: The Utilization Review (UR) Coordinator collaborates with a ... Maintains professional competency through ongoing education and self-directed learning. 24.
Day Shift Description: The Utilization Review (UR) Coordinator collaborates with a ... Maintains professional competency through ongoing education and self-directed learning. 24.
Day Shift Description: The Utilization Review (UR) Coordinator collaborates with a ... Maintains professional competency through ongoing education and self-directed learning. 24.
Day Shift Description: The Utilization Review (UR) Coordinator collaborates with a ... Maintains professional competency through ongoing education and self-directed learning. 24.
Refers appropriate cases to the Medical Director for review. Refer to and work closely with Case ... Plans, implements, and documents utilization management activities which incorporate a thorough ...
Refers appropriate cases to the Medical Director for review. Refer to and work closely with Case ... Plans, implements, and documents utilization management activities which incorporate a thorough ...
Refers appropriate cases to the Medical Director for review. Refer to and work closely with Case ... Plans, implements, and documents utilization management activities which incorporate a thorough ...
Refers appropriate cases to the Medical Director for review. Refer to and work closely with Case ... Plans, implements, and documents utilization management activities which incorporate a thorough ...
Refers appropriate cases to the Medical Director for review. Refer to and work closely with Case ... Plans, implements, and documents utilization management activities which incorporate a thorough ...
Refers appropriate cases to the Medical Director for review. Refer to and work closely with Case ... Plans, implements, and documents utilization management activities which incorporate a thorough ...
Director of Utilization Management
Troy, MI · On-site +1
$160K - $160K/yr
Prepare and maintain Utilization Review Plan policies and procedures * Obtain or maintain certification or license in states when performing Utilization Review * Work with Chief Medical Director to ...
Director of Utilization Management
Troy, MI · On-site +1
$160K - $160K/yr
Prepare and maintain Utilization Review Plan policies and procedures * Obtain or maintain certification or license in states when performing Utilization Review * Work with Chief Medical Director to ...
Reviews and coordinates PDPM, Medicare management, managed care, and case mix data for assigned area to ensure appropriate utilization of available resources. Collaborates with corporate, regional ...
Quick apply
Reviews and coordinates PDPM, Medicare management, managed care, and case mix data for assigned area to ensure appropriate utilization of available resources. Collaborates with corporate, regional ...
Reviews and coordinates PDPM, Medicare management, managed care, and case mix data for assigned area to ensure appropriate utilization of available resources. Collaborates with corporate, regional ...
Reviews and coordinates PDPM, Medicare management, managed care, and case mix data for assigned area to ensure appropriate utilization of available resources. Collaborates with corporate, regional ...
Director Optum Utilization Review information
What is the difference between Director Optum Utilization Review vs Utilization Review Manager?
| Aspect | Director Optum Utilization Review | Utilization Review Manager |
|---|---|---|
| Certifications | Typically requires certifications like CCM or URAC accreditation | Often requires similar certifications, may vary by employer |
| Work Environment | Works within Optum or similar healthcare organizations, overseeing utilization review processes | Manages utilization review teams, often within healthcare providers or insurance companies |
| Responsibilities | Strategic oversight of utilization review policies, compliance, and team leadership | Supervises daily review operations, staff management, and process improvements |
The main difference is that the Director Optum Utilization Review typically holds a higher strategic leadership role within Optum, focusing on policy and compliance, while the Utilization Review Manager manages daily operations and staff. Both roles require similar credentials but differ in scope and level of responsibility.
What are the most commonly searched types of Optum Utilization Review jobs in Michigan?
The most popular types of Optum Utilization Review jobs in Michigan are:
What are popular job titles related to Director Optum Utilization Review jobs in Michigan?
For Director Optum Utilization Review jobs in Michigan, the most frequently searched job titles are:
- Remote Utilization Management Nurse
- Weekend Physician Advisor Utilization Review
- Registered Nurse Utilization Review
- Full Time Physician Advisor Utilization Review
- Rn Legal Nurse Chart Review
- Flex Schedule Remote Utilization Review Nurse
- Optum Clinical Claim Review Nurse
- Appeals Nurse
- No Experience Utilization Management Nurse
- Temporary Utilization Review Nurse
What job categories do people searching Director Optum Utilization Review jobs in Michigan look for?
The top searched job categories for Director Optum Utilization Review jobs in Michigan are:
- Rn Utilization Review Nurse
- Remote Aetna Utilization Review Nurse
- Commission Authorization Utilization Review Bcba
- Locum Medical Utilization Review Physician
- Remote Navihealth Utilization Review
- Utilization Review Manager
- Volunteer Navihealth Utilization Review
- Manager Aetna Utilization Review
- Behavioral Utilization Review
- Remote Utilization Review
What cities in Michigan are hiring for Director Optum Utilization Review jobs?
Cities in Michigan with the most Director Optum Utilization Review job openings:
Acadia Healthcare rating
6.2
Based on 190 frontline employees who took The Breakroom Quiz
698th of 891 rated healthcare providers
Job description
Join StoneCrest Center, a 182-bed behavioral health hospital in Detroit, Michigan, dedicated to providing compassionate, evidence-based psychiatric care for adolescents, adults, and seniors. StoneCrest offers comprehensive inpatient treatment for a wide range of mental health and co-occurring substance use disorders, with specialized programming for adolescents, older adults, and individuals requiring acute crisis stabilization. The hospital's multidisciplinary approach includes psychiatry, nursing, case management, family therapy, recreational therapy, and other therapeutic services designed to help patients achieve lasting recovery and improved quality of life.
As the Director of Utilization Review, you will play a critical leadership role in ensuring the delivery of high-quality, medically necessary behavioral healthcare while optimizing patient outcomes and reimbursement processes. This is an opportunity to join a mission-driven organization where clinical excellence, collaboration, and patient-centered care are at the heart of everything we do.
PURPOSE STATEMENT:
Direct and manage the day-to-day operations of the Utilization Review department.
ESSENTIAL FUNCTIONS:
- Monitor utilization of services and optimize reimbursement for the facility while maximizing use of the patient’s provider benefits for their needs.
- Conducts and oversees concurrent and retrospective reviews for all patients.
- Act as a liaison between Medicaid reviewers and the staff completing required paperwork to facilitate the Utilization Review process.
- Collaborates with physicians, therapist and nursing staff to provide optimal review based on patient needs.
- Collaborates with ancillary services in order to prevent delays in services.
- Evaluates the UM program for compliance with regulations, policies and procedures.
- May review charts and make necessary recommendations to the physicians, regarding utilization review and specific managed care issues.
- Provide staff management to including hiring, development, training, performance management and communication to ensure effective and efficient department operation.
OTHER FUNCTIONS:
- Perform other functions and tasks as assigned.
EDUCATION/EXPERIENCE/SKILL REQUIREMENTS:
- Bachelor's Degree in nursing or other clinical field required. Master's Degree in clinical field preferred.
- Six or more year's clinical experience with the population of the facility preferred.
- Four or more years’ experience in utilization management required.
- Three or more years of supervisoryexperience required.
LICENSES/DESIGNATIONS/CERTIFICATIONS:
- If applicable, current licensure as an LPN or RN within the state where the facility provides services; or current clinical professional license or certification, as required, within the state where the facility provides services.
We are committed to providing equal employment opportunities to all applicants for employment regardless of an individual’s characteristics protected by applicable state, federal and local laws.
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About Acadia Healthcare
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Acadia Healthcare is a leading provider in the healthcare and hospital industry, based in Franklin, Tennessee, United States. The company is recognised for its commitment to creating a behavioural health network that provides accessible, high-quality treatment options for individuals suffering from mental health issues, addiction, eating disorders, and PTSD. Acadia Healthcare was founded in 2005, with the mission to create a world-class organization that sets the standard of excellence in the treatment of specialty behavioural health and addiction disorders.
Industry
Hospitals
Company size
10,000+ Employees
Headquarters location
Franklin, TN, US
Year founded
2005