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Santa Clara Family Health Plan

Director of Utilization Management

Id Job: 3172774

🏢 On-site
💼 Santa Clara Family Health Plan
📍 San Jose, CA
🕒 1 day ago
💰 158013 – 252821 USD ANNUAL

Job Description

About Us:

Santa Clara Family Health Plan (SCFHP) is a local, community-based health plan dedicated to improving the health and well-being of the residents of Santa Clara County. Working in partnership with providers and community organizations, we serve our neighbors through our Medi-Cal and Cal MediConnect (Medicare-Medicaid Plan) health insurance plans.

About the role:

The Director of Utilization Management (UM) is responsible for the clinical and operational management of the Utilization Management Department activities including utilization management, concurrent review, prior authorization, care coordination, discharge planning, retrospective review, and claims support, including staff management to ensure that all administrative utilization management (UM) processes are performed in accordance with applicable state and federal regulatory requirements, SCFHP policies and procedures and business requirements.

Day to Day:

About You:

Please review the full job description on our Career’s page: https://phf.tbe.taleo.net/phf04/ats/careers/v2/viewRequisition?org=SANTCLAR2&cws=38&rid=2888

Job Type: Full-time

Pay: $158,013.00 - $252,821.00 per year

Benefits:

Schedule:

Application Question(s):

Education:

Experience:

License/Certification:

Work Location: In person

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