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Baylor Scott & White Health

Frisco, Texas

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Geisinger

Wilkes-Barre, Pennsylvania

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Desert Regional Medical Center

Palm Springs, California

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Valley Baptist Medical Center - Harlingen

Harlingen, Texas

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Banner Health

Phoenix, Arizona

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Desert Regional Medical Center

Palm Springs, California

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Mission Trail Baptist Hospital

San Antonio, Texas

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Banner Health

Queen Creek, Arizona

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Veterans Affairs, Veterans Health Administration

Houston, Texas

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MemorialCare Health System

Long Beach, California

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LifeStance Health

Gladstone, OR

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Sunbury, Pennsylvania

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Dade City, Florida

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LifeStance Health

Nashua, NH

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Vanderbilt Health

Nashville, Tennessee

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Vanderbilt Health

Nashville, Tennessee

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DMC Rehabilitation Institute of Michigan

Detroit, Michigan

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Geisinger

State College, Pennsylvania

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Lewistown, Pennsylvania

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Director, Utilization Management
The Director, Utilization Management is reponsible for direct supervision of Utilization Review nursing staff: Onsite and telephonic review including discharge planning activities and case management to include tracking and trending inpatient and outpatient utilization, provider corrective action for utilization trends that have variances and reporting the UM statistical data to the Medical Director. Direct supervision of the Retrospective review and Appeals team: including tracking and trending types of retrospective reviews and appeals, overturns, fair hearing and IRO results and assuring turnaround times are met. Responsibilities also include compliance with THHSC regulations for conveying adverse determinations decisions to Community Health Choice (Community) provid


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