About this opportunity
Insight Global lists this Utilization Management Director opportunity in washington, District of Columbia. Review the employer’s description below for duties, qualifications and application requirements.
Job description
Concurrent Reviews
Proven people leadership experience.
Strong operational improvement, program management, and change leadership background.
Excellent communication and stakeholder management skills.
Preferred Qualifications
Managed care/payor experience preferred.
Medicaid experience strongly preferred.
Experience leading operations across multiple markets.
Combination of provider and payer experience highly desirable
Job description:
We are seeking a strategic and results-driven Director of Utilization Management to lead Utilization Management operations across the DC and Maryland markets. This role is ideal for an experienced healthcare leader with deep expertise in managed care, utilization management, appeals and grievances, and concurrent review programs.
The Director will be responsible for driving operational excellence, improving team performance, and enhancing the effectiveness of UM programs while supporting members, providers, and organizational stakeholders.
Key Responsibilities
Oversee Appeals & Grievances processes to ensure quality, consistency, and compliance.
Direct Concurrent Review operations and performance improvement initiatives.
Develop and execute strategic initiatives that improve efficiency, outcomes, and member experience.
Partner with executive leadership to identify and implement operational enhancements.
Build, mentor, and develop high-performing UM teams.
Drive change management efforts and foster a culture focused on accountability and continuous improvement.
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Worksite address
washington, DC, 20022, US
Who can apply
Review the original listing for work authorization, qualifications and employer requirements.