Utilization Review / Utilization Management Director - PPO

Springfield, Massachusetts, United States · Springfield

Description

Create, build and maintain a comprehensive Utilization Management program utilizing vendors, tools and internal and external resources. Ensure medically appropriate, high quality, cost effective care for inpatient admissions, outpatient services, surgical and diagnostic procedures and out of network services. Drive positive outcomes by supporting all stakeholders including patient, family, caregivers, providers, SHIP clients, and our UM vendors.


Responsibilities

Requirements

Benefits

Generous salary plus excellent healthcare benefits and PTO

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