A Clinical Director directs and manages a medical practice, clinic, hospital, or other clinical setting. Organizes and manages of staff physicians, policy implementation, and ensures that standards for medical care are communicated and maintained.
Job Summary To Apply for this Job Click Here An established behavioral health hospital is seeking a Director of Utilization Management to lead its Utilization Management program. This high-impact leadership role offers the chance to collaborate with respected clinical teams and make a meaningful difference in patient care, regulatory compliance, and reimbursement optimization.
Director of Utilization Management Benefits & Compensation:
Competitive compensation and comprehensive benefits package Executive-level position with organization-wide visibility Opportunity to drive improvements in clinical and financial outcomes Collaborative, supportive leadership culture Stable, mission-driven organization committed to behavioral health
Director of Utilization Management Requirements & Qualifications:
Current California RN license required 5+ years of leadership experience in Utilization Management or Utilization Review Experience in behavioral health, psychiatric hospital, or acute care settings Strong knowledge of behavioral health utilization management, concurrent review, denial management, appeals, and reimbursement Experience with Medi-Cal, Medicare, commercial payers, and California behavioral health regulations Proven leadership, communication, and team development skills
Director of Utilization Management Preferred Background & Skills:
Familiarity with Carelon Behavioral Health and Orange County behavioral health systems
Director of Utilization Management Day-to-Day Responsibilities:
Lead all Utilization Management and Utilization Review operations Supervise and develop Utilization Management and Social Services teams Oversee concurrent review, payer authorizations, appeals, denial management, and reimbursement optimization Ensure compliance with California regulations, Medi-Cal, Medicare, commercial payers, and accreditation standards Collaborate with physicians, clinical leadership, and care teams to improve patient flow, length of stay, and discharge planning Build and maintain relationships with managed care organizations, county agencies, and community providers Monitor utilization trends, quality metrics, and financial performance to drive process improvements Provide education and support to clinical staff on utilization management best practices Join a respected leader in behavioral health and help shape the future of patient care through strategic leadership and partnership.
JOB ID :
179916 #post Melissa Rundle To Apply for this Job Click Here Apply Now Share This Job Share on Email Share on Linkedin Share on Facebook đť•Ź Share on X Share on Email
