Utilization Management Manager

Welcome to Kaiser Permanente, where we are committed to providing high-quality, affordable healthcare to our members. We are currently seeking a Utilization Management Manager to join our team and play a vital role in ensuring efficient and effective use of resources. As the Utilization Management Manager, you will oversee the utilization management process, monitor utilization trends, and work with interdisciplinary teams to develop and implement strategies for improving quality and reducing costs. We are looking for a dynamic and experienced individual with a strong background in healthcare management and utilization management who is passionate about making a positive impact on our members' health outcomes. If you are a driven and innovative leader with a dedication to delivering exceptional care, we encourage you to apply for this exciting opportunity.

1. Oversee the utilization management process for Kaiser Permanente, ensuring that resources are used efficiently and effectively to provide high-quality and affordable healthcare to members.
2. Monitor utilization trends and identify areas for improvement, working with interdisciplinary teams to develop and implement strategies for optimizing resource allocation.
3. Collaborate with healthcare providers to ensure that members receive appropriate and timely care.
4. Manage a team of utilization management staff, providing guidance and support to ensure that all utilization management activities are in line with company policies and procedures.
5. Review and analyze data to identify potential issues or areas for improvement, and develop action plans to address them.
6. Keep abreast of industry trends and changes in healthcare regulations to ensure compliance and make recommendations for adjustments to utilization management processes.
7. Develop and maintain relationships with external stakeholders, such as insurance companies and regulatory bodies, to ensure alignment and cooperation in utilization management efforts.
8. Train and educate staff on utilization management processes and best practices to ensure consistent and high-quality performance.
9. Conduct performance evaluations and provide coaching and feedback to team members to promote professional development and growth.
10. Participate in the development and implementation of policies and procedures related to utilization management.
11. Act as a key point of contact for any utilization management related inquiries or concerns from internal and external stakeholders.
12. Continuously evaluate and improve utilization management processes to promote efficiency and cost-effectiveness while maintaining high-quality care for members.

According to JobzMall, the average salary range for a Utilization Management Manager in Hyattsville, MD, USA is $99,000 - $119,000 per year. This can vary depending on the specific company, experience level, and other factors.

Kaiser Permanente is an American integrated managed care consortium, based in Oakland, California, United States, founded in 1945 by industrialist Henry J. Kaiser and physician Sidney Garfield.