Utilization Management Director - Inpatient (Hybrid)

**Resp & Qualifications**

**PURPOSE:**
The Director Utilization Management (Inpatient) provides strategic leadership of the inpatient utilization management team and is responsible for the design, assessment, implementation and outcomes of inpatient utilization management strategies using a multidisciplinary approach to enhance member engagement, improve access to quality care and the use of cost-effective health resources. Establishes performance metrics to ensure the needs and requirements of our members, providers, and regulators are met in accordance with accreditation standards, CMS requirements and state, Federal and local laws, and in alignment with CareFirst's business strategy. Plans, directs and evaluates the full scope of utilization management services offered in collaboration with the preservice UM Director, and works closely with leadership, members, providers, vendors, accounts, and other strategic business partners.

Plans, organizes, and manages in...