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    • Market Director of Utilization Management - Nashville, TN - Ascension

    Ascension
    Ascension Nashville, TN

    1 month ago

    Ascension background
    Description

    Job Description

    We are seeking an experienced Director of Utilization Management to lead our clinical discussions during Payer JOC meetings, oversee denial management activities, and perform root-cause analysis to enhance our processes.

    Key Responsibilities

    • Ensure integration of utilization management functions with network strategy and claims processing.
    • Oversee work with provider relations on resolving issues.
    • Manage staffing activities, 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.

    Requirements

    • Registered Nurse credentialed from the Tennessee Board of Nursing obtained prior to hire date or job transfer date required.
    • Bachelor's degree in nursing or diploma from an accredited school/college of nursing required.
    • 5 years of experience required, 10 years of experience preferred.

    Estimated Salary

    $110,000 - $140,000 per year, based on location and qualifications.

    Benefits

    Ascension offers a comprehensive benefits package, including paid time off, various health insurance options, retirement benefits, long-term and short-term disability, employee assistance programs, parental leave, adoption assistance, tuition reimbursement, and ways to give back to the community.

    Why Join Our Team

    Ascension is a leading non-profit, faith-based national health system made up of thousands of associates delivering compassionate, personalized care across hospitals, clinics, and senior living communities.

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