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Sierra Vista Regional Medical Center Logo
Sierra Vista Regional Medical Center

San Luis Obispo, California

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Doctors Medical Center of Modesto Logo
Doctors Medical Center of Modesto

Modesto, California

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LifeStance Health

Atlanta, GA

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Vanderbilt Health

Nashville, Tennessee

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Banner Health

Tucson, Arizona

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Banner Health

Chandler, Arizona

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AdventHealth

Orlando, Florida

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Baptist Medical Center

San Antonio, Texas

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Marshfield Clinic Health System

Marshfield, WI, Wisconsin

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The George Washington University Hospital

Washington, D.C.

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LifeStance Health

Macon, GA

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Veterans Affairs, Veterans Health Administration

Bloomington, Indiana

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AdventHealth

Orlando, Florida

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Delray Medical Center

Delray Beach, Florida

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Saint Mary's Medical Center

West Palm Beach, Florida

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Fairview Health Services

Saint Paul, Minnesota

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Vanderbilt Health

Nashville, Tennessee

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Banner Health

Mesa, Arizona

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Encompass Health

Newburgh, Indiana

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LifeStance Health

Tualatin, OR

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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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