Director of Utilization Management
Tammany(1 month ago)
About this role
The Director of Utilization Management at St. Tammany Health System provides strategic oversight of the system’s utilization review and medical necessity programs to ensure appropriate levels of care and compliance with regulations. The role supports efficient patient flow and high-quality clinical outcomes through collaboration with clinical and administrative teams across the health system.
Required Skills
- Utilization Management
- Case Management
- Regulatory Compliance
- Managed Care
- Patient Throughput
- Clinical Leadership
- Revenue Cycle
- Nursing
- Medical Necessity
- Denial Management
Qualifications
- Bachelor's Degree (Nursing or related)
- RN License
- Master's Degree (preferred)
- CCM or ACM Certification (preferred)
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