Utilization Management Director, RN Required
Northeast Georgia Health System
full-time
Posted on:
Location Type: Remote
Location: United States
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Job Level
About the role
- Oversee day-to-day operations of the Utilization Management Department
- Ensure compliance with payer requirements and regulatory standards
- Monitor and analyze key performance indicators (KPIs)
- Recruit, train, and manage a high-performing UM team
- Manage departmental budgets and financial responsibility
- Develop and implement performance metrics
Requirements
- Registered Nurse license
- UR specific certification preferred (CCM, ACM, CPUR)
- Bachelors Degree
- Minimum of 7 years UR experience
- 2 years progressive Revenue Cycle leadership experience
- Proven ability to lead teams and manage budgets
- Strong ability to educate and influence on UM best practices
- Experience in data analysis and performance improvement strategies
- Expertise in medical necessity criteria and payer regulations
Benefits
- Health insurance
- 401(k) retirement plans
- Paid time off
- Professional development opportunities
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills & Tools
data analysisperformance improvement strategiesbudget managementkey performance indicators (KPIs)medical necessity criteriapayer regulations
Soft Skills
leadershipteam managementeducationinfluence
Certifications
Registered Nurse licenseCCMACMCPUR