Market Director - Utilization Management

Utilization Management Director

Full-time, Day shift. Monday - Friday

Remote (4 Directors to support regions)

Region 1 : FL, IL, MD

Region 2 : TN, WI

Region 3 : IN, KS

Region 4 : OK, TX

$118,129 - $158,821 (per year) Eligible for annual bonus incentive

Paid time off (PTO)

Various health insurance options & wellness plans

Retirement benefits including employer match plans

Long-term & short-term disability

Employee assistance programs (EAP)

Parental leave & adoption assistance

Tuition reimbursement

Ways to give back to your community

Benefit options and eligibility vary by position. Compensation varies based on factors including, but not limited to, experience, skills, education, performance, location and salary range at the time of the offer.

Provides operations oversight of the Ascension Utilization Management program across the Ministry Markets assigned and directs tactics to support strategic goals.

• Ensure integration of utilization management functions with network strategy and claims processing.
• Oversee work with provider relations on resolving issues.
• Manage activities related to staffing, including hiring, orienting, evaluating, disciplinary actions, and continuing education initiatives.
• Develop systems and processes for prospective, concurrent and retrospective utilization review for all self-funded and fully insured clients to implement and manage comprehensive outpatient and inpatient utilization management programs.
• Oversee implementation and maintenance of prior authorization codes for all clients.
• Directs the implementation of tactics to support strategic goals and denial prevention action items.
• Supports interactions with revenue cycle units and physician advisors.
• Accountable for performance of UM clinical operations and supporting achievement of KPI targets.

Licensure / Certification / Registration :

Education :

Work Experience :

#LI-Remote

Ascension associates are key to our commitment of transforming healthcare and providing care to all, especially those most in need. Join us and help us drive impact through reimagining how we can deliver a people-centered healthcare experience and creating the solutions to do it. Explore career opportunities across our ministry locations and within our corporate headquarters.

Ascension is a leading non-profit, faith-based national health system made up of over 134,000 associates and 2,600 sites of care, including more than 140 hospitals and 40 senior living communities in 19 states.

Our Mission, Vision and Values encompass everything we do at Ascension. Every associate is empowered to give back, volunteer and make a positive impact in their community. Ascension careers are more than jobs; they are opportunities to enhance your life and the lives of the people around you.

Ascension provides Equal Employment Opportunities (EEO) to all associates and applicants for employment without regard to race, color, religion, sex / gender, sexual orientation, gender identity or expression, pregnancy, childbirth, and related medical conditions, lactation, breastfeeding, national origin, citizenship, age, disability, genetic information, veteran status, marital status, all as defined by applicable law, and any other legally protected status or characteristic in accordance with applicable federal, state and local laws.

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