- Compensation: $140, $180,000.00 per year
- Required Qualifications:
- Healthplan Experience + Medicare Advantage
- 3-5 years Management Experience
- RN in CA
- Daily audits of UM until they are in full compliance - CMS + Health Plan audits
- Work in company
Forensics and Litigation Services Director or Managing Director
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Utilization Management Director - Pasadena - AMI Network
Description
AMI Network is partnered with a large healthplan organization to find their next Utilization Management Director in Pasadena.
If your skills, experience, and qualifications match those in this job overview, do not delay your application.Our client is a leading Health Plan + IPA that offers full-service Medicare Advantage coverage across multiple counties in California, currently serving over 60k+ members from major Health Plans like Anthem, SCAN, and Alignment Health.
As the Utilization Review Director, you'll oversee 4 direct reports on the IPA side (UM supervisors + coordinator), and play a crucial role in providing operational leadership to the UM/Prior Authorization and Inpatient Teams (50 FTEs in total). You'll be responsible for CMS + Health Plan audits, and ensuring compliance with Federal, State, Health Plan, and NCQA requirements.
This role offers a competitive salary in the ballpark of $180k (give or take based on experience) -Plus great benefits: 3 weeks PTO, 8 Holidays, 401k + matching, HMO or PPO Medical/Dental, vision, and life insurance.
This is an onsite position- no remote options are available at this time. xhmxlyz
Requirements:
APPLY NOW if you're interested in taking the next big step in your career
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Sr. Manager/Director
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Managing Director
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Managing Director
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Managing Director
Only for registered members Los Angeles
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Sr Director Product Management, Tax Solutions
Only for registered members Pasadena, CA
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Managing Director
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