Administrative

Director of Utilization Review & Management

Indianapolis, Indiana   |   Full time

Essential Recruiting Resources, LLC. is a boutique recruiting firm based in Nashville, TN. that works with clients all over the globe to find them the talent needed for their businesses to be successful.


One of our favorite clients is leader in the healthcare industry and they are looking for a Director of Utilization Management that knows how to lead, inspire and engage their Team!


This Leader will oversee operations of the referral management, telephonic utilization review, prior authorization functions, and case management programs.


They will support and perform case management, disease management and on site concurrent review functions as necessary while providing support on Provider Relations issues related to Utilization issues for hospitals and physician providers. Developing, implementing and maintaining policies and procedures regarding the prior authorization functions will be a key focus in this role.


The Director will work with their Team to identify quality and risk management issues and facilitate the collection of information for quality improvement and reporting purposes.


Qualifications:
Education/Experience: Bachelor's degree in Nursing or equivalent experience.
-5+ years of nursing experience in an acute care setting or medical/surgical, pediatrics, or obstetric in a managed care environment.
-1+ years of utilization management and/or case management experience.
-Previous management experience including responsibilities for hiring, training, assigning work and managing performance of staff


Licenses/Certifications: An active RN license in the state of IN


Our client offers an outstanding total compensation package with benefits including but not limited to medical, dental and vision insurance options as well as a 401K and paid time off (PTO).

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