Regional Director of Utilization Management

Lead regional operational leadership for Utilization Management services, directly supervising Utilization Review Managers and establishing accountability for quality, productivity, and financial performance. Oversee initial authorization and concurrent review activities, monitor authorization status to minimize care interruptions, and ensure timely clinical documentation submission to payers. Collaborate with physicians and clinical teams to improve documentation quality, maximize medically appropriate stays, and escalate complex authorization issues. Partner with facility leadership, Centralized Admissions, and Revenue Cycle teams to reduce denials, implement standardized workflows, and drive continuous process improvement. Build collaborative relationships with payer representatives, participate in operational reviews, and develop regional action plans based on performance metrics including denial rates, approval timeliness, and revenue at risk. Create corrective action plans when targets are not achieved to ensure compliance with payer and regulatory requirements.