Manager - Utilization Management

Welcome to Orlando Health, where we are dedicated to providing exceptional healthcare services to our community. We are currently seeking a highly skilled and experienced Manager of Utilization Management to join our team. In this role, you will be responsible for overseeing the utilization management process, ensuring that our patients receive the appropriate level of care while also managing healthcare costs. If you are a strategic thinker with a strong background in healthcare management and a passion for improving patient outcomes, we want to hear from you. Join us in our mission to make a positive impact on the lives of our patients every day.

1. Develop and implement utilization management policies and procedures in accordance with industry standards and regulations.
2. Monitor and evaluate utilization management processes to identify areas for improvement and implement necessary changes.
3. Coordinate with healthcare providers to ensure that patients receive the appropriate level of care while managing costs.
4. Collaborate with various departments, including finance and clinical teams, to develop and implement cost-effective utilization management strategies.
5. Oversee the utilization review process, including pre-authorization and concurrent reviews, to ensure timely and accurate determinations.
6. Analyze utilization data and trends to identify opportunities for cost savings and quality improvement.
7. Train and educate staff on utilization management processes and procedures.
8. Ensure compliance with all regulatory requirements related to utilization management.
9. Develop and maintain relationships with external partners, such as insurance companies and referral sources.
10. Serve as a liaison between the utilization management department and other departments within the organization.
11. Develop and manage budgets for the utilization management department.
12. Stay up-to-date on industry trends and best practices related to utilization management.
13. Provide regular reports and updates to senior management on utilization management performance and outcomes.
14. Oversee the hiring, training, and performance management of utilization management staff.
15. Foster a positive and collaborative work environment within the utilization management team.

According to JobzMall, the average salary range for a Manager - Utilization Management in Orlando, FL, USA is between $73,000 - $110,000 per year. This may vary depending on the specific company, years of experience, and other factors.

Orlando Health is a private, not-for-profit network of community and specialty hospitals based in Orlando, Florida. Orlando Health has award-winning hospitals, clinics and over 2000 physicians throughout Central Florida.