- Troy, Michigan, United States
- 7–10 years
Lead and oversee utilization management operations, ensuring compliance with regulatory standards and improving clinical and operational outcomes for Oakland Community Health Network.
Responsibilities
- Provide executive leadership and strategic oversight of utilization management functions
- Develop and implement utilization management strategies aligned with organizational mission and regulatory obligations
- Ensure compliance with MDHHS, Medicaid, NCQA, and CARF standards
- Lead development of policies, procedures, and clinical review standards
- Monitor authorization workflows and implement process improvements
Requirements
- Master's degree in Healthcare Administration
- Public Health
- Social Work
- Nursing
- Psychology