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Director, Utilization Case Management
The Director of Utilization Case Management responsibilities: Developing & administering policies & procedures for UM of inpatient services. Assisting in the development & implementation of procedures to track length of stay and level of care for admission. Monitoring the process for clinical reviews & making recommendations to the VP of Business Operations on strategies to maximize revenue, prevent loss, contain costs, improve access and insure quality care. Assuring compliance with Federal, State, JACHO, NCQA, & other regulatory agencies and internal standards. Identifying risk management & quality of care issues across the continuum. Maintaining relationships with departments & external providers & payers who provide
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